Single Operation Research Articles

Ultrafast Molecular Diagnosis‐Based Solid‐Phase Photonic PCR for Respiratory Pathogen Variant Discrimination

AbstractThe need for an accurate and rapid diagnosis platform for highly contagious viruses, such as pandemic viruses, has rapidly increased. Conventional diagnostic methods in the initial stage of quarantine for the prevention of epidemic spread have encountered limitations such as a long operation time, occupation of a large space, and high cost per single operation. Here, a highly sensitive and selective portable diagnostic platform based on solid‐phase photonic polymerase chain reaction (SP‐PCR) is reported. The thermal cycle is operated by the photothermal energy converted from the photon energy of a light‐emitting diode (LED) through a gold layer to phonons. The formation of an amplicon, which is immobilized through N‐heterocyclic carbene, is confirmed through fluorescence on the surface of the miniaturized SP‐PCR chip. The practical applicability of the newly developed diagnosis platform for the recognition of the presence of a SARS‐CoV‐2‐specific genome sequence is demonstrated utilizing 100 clinical samples, including 72 COVID‐19‐positive clinical samples and 28 negative samples.

50 years of inflatable penile implants: Where do we stand in France?

IntroductionWith 50 years’ experience, inflatable penile implants are the preferred option for erectile dysfunction refractory to pharmacological and mechanical treatment. Technical and surgical improvements have optimized patient success and satisfaction. However, multi-factorial dissatisfaction persists. ObjectiveThe aim of this study is to provide an overview of available technological improvements and innovations, as well as the perioperative management and complications of inflatable penile implant surgery. MethodA literature review was carried out over the last twenty years to answer 4 questions: what are the different inflatable penile implants available in 2023, for which indications, results and complications. ResultsFour companies propose inflatable penile implants in France. The main improvements have been in the various components of the prosthesis with better cylinder extension, more ergonomic reservoirs, and more manageable pumps, leading to a better durability. Indications have been extended to patients suffering from Peyronie's disease and in emergency cases of priapism. In response to demand from the transgender population, specific phalloplasty implants have been developed. New options are being developed for difficult cases of retracted penis. Results show a high satisfaction rate. Currently the main challenge is the management of infection with the development of rescue protocols using antibiotics to preserve implants – or replace them in a single operation. ConclusionAfter 50years’ experience, improvements in penile implants led to effective, satisfactory and safe treatment and can be proposed in new indications. Further development is sill necessary to offer solutions in difficult cases.

MASNet: mixed attention Siamese network for visual object tracking

Most Siamese-based trackers adopt correlation operation to perform similarity matching on feature fusion of template branch and search branch. However, the correlation operation directly uses the template feature to slide the window on the search area feature, and it is difficult to distinguish the target and background information when encountering similar target interference and background clutter, which can easily lead to tracking failure. In this paper, a mixed attention Siamese Network (MASNet) is proposed, which neatly integrates the modelling of global information and mutual information into the Siamese tracking framework. Specifically, through the learnable attention module, the local and global dependencies are adaptively integrated, and the rich context information is captured to improve the discrimination of the network for similar targets. After that, the correlation of the context information of the two branches is aggregated and adaptively encoded into the two branches, which makes up for the shortcomings of single correlation operation. In addition, the framework adopts a three-layer feature fusion method, which enables the tracker to better adapt to object deformation and similar object interference. Extensive experiments on OTB100, UAV123, GOT-10k and LaSOT show that the proposed tracking method achieves comparable performance to the advanced trackers.

Coupled cluster finite temperature simulations of periodic materials via machine learning

Density functional theory is the workhorse of materials simulations. Unfortunately, the quality of results often varies depending on the specific choice of the exchange-correlation functional, which significantly limits the predictive power of this approach. Coupled cluster theory, including single, double, and perturbative triple particle-hole excitation operators, is widely considered the ‘gold standard' of quantum chemistry as it can achieve chemical accuracy for non-strongly correlated applications. Because of the high computational cost, the application of coupled cluster theory in materials simulations is rare, and this is particularly true if finite-temperature properties are of interest for which molecular dynamics simulations have to be performed. By combining recent progress in machine learning models with low data requirements for energy surfaces and in the implementation of coupled cluster theory for periodic materials, we show that chemically accurate simulations of materials are practical and could soon become significantly widespread. As an example of this numerical approach, we consider the calculation of the enthalpy of adsorption of CO2 in a porous material.

Pre-operative spine tumour embolization: Clinical outcomes and effect of embolization completeness.

To assess the association between the impact of the completeness of pre-operative spine tumour embolisation and clinical outcomes, including estimated blood loss (EBL), neurological status and complications. Retrospective chart review of all preoperative spine tumour embolisation procedures performed over 11 years by a single operator (2007-2018) at Vancouver General Hospital on 44 consecutive patients (mean age 57; 77% males) with 46 embolisation procedures, of which surgery was done en bloc in 26 cases and intralesional in the remaining 20. A multivariable negative binomial regression model was fit to examine the association between EBL and surgery type, tumour characteristics, embolisation completeness and operative duration. Among intralesional surgeries, complete versus incomplete embolisation was associated with reduced blood loss (772 vs 1428 mL, P < 0.01). There was no statistically significant difference in neurological outcomes or complications between groups. Highly vascular tumours correlated with greater blood loss than their less vascular counterparts, but tumour location did not have a statistically significant effect. This study provides evidence in support of our hypothesis that complete as opposed to incomplete tumour embolisation correlates with reduced blood loss in intralesional surgeries. Randomised control trials with larger samples are necessary to confirm this benefit and to ascertain other potential clinical benefits.

Assessment of Bacterial Load and Post-Endodontic Pain after One-Visit Root Canal Treatment Using Two Types of Endodontic Access Openings: A Randomized Controlled Clinical Trial.

The need for controlling bacteria and pain during root canal therapy is undeniable. This clinical trial aimed to assess whether there is a difference in colony-forming unit (CFU) reduction after instrumentation and post-endodontic pain after root canal treatment (RCT) using a traditional endodontic cavity (TEC) versus a conservative endodontic cavity (CEC). This clinical study was conducted on 89 patients designated for a single-visit RCT. Patients were allocated randomly (TEC n = 45 and CEC n = 44). The access opening was gained accordingly in each group by a single operator. A pre-instrumentation sample of root canal dentin was collected using an endodontic file; the second sample was collected similarly, right after shaping and cleaning the root canal. The CFU was calculated based on the samples collected. The pain level was recorded preoperatively and at 1, 7, and 21 days postoperatively utilizing a visual analog scale (VAS). There were no statistically significant differences in the CFU reduction between the TEC and CEC groups (p > 0.05). Additionally, there were no statistically significant differences found in postoperative pain levels between the TEC and CEC at 1, 7, and 21 days (p > 0.05). Despite the limitations of this study, both the CEC and TEC demonstrate a decrease in bacteria within the root canals and alleviate postoperative pain with no difference between them.

Analysis of multimode radiation from 0.4 THz backward wave oscillator

Abstract A terahertz backward wave oscillator (BWO) is a high-power terahertz wave source based on the Cherenkov interaction between an electron beam and a slow backward wave. Excitation of slow wave modes with different mode numbers degrades the performance of BWO due to mode competition. Analyzing the mode spectrum is a difficult challenge to confirm single mode operation. In this study, the excitation of the slow waves in a 0.4 THz cylindrical corrugated waveguide is examined. In the corrugated waveguide, azimuthal modes become slow backward waves with evanescent fields. We found the superposition of the modes with different azimuthal indices has an asymmetric field intensity and the excitation of the superposed modes produces the terahertz radiation with the asymmetric pattern. We conduct a BWO experiment using a 0.4 THz corrugated waveguide. The experimental radiation pattern is obtained and corresponds well to the calculated asymmetric pattern. The symmetry of the radiation can be regarded as an indicator of the mode control.

High-Power Emission via Large-Area VCSELs With Single High-Order Mode Operation

High-Power Emission via Large-Area VCSELs With Single High-Order Mode Operation

Relationship between staff and quality of care in care homes: StaRQ mixed methods study.

Quality of life and care varies between and within the care homes in which almost half a million older people live and over half a million direct care staff (registered nurses and care assistants) work. The reasons are complex, understudied and sometimes oversimplified, but staff and their work are a significant influence. To explore variations in the care home nursing and support workforce; how resident and relatives' needs in care homes are linked to care home staffing; how different staffing models impact on care quality, outcomes and costs; how workforce numbers, skill mix and stability meet residents' needs; the contributions of the care home workforce to enhancing quality of care; staff relationships as a platform for implementation by providers. Mixed-method (QUAL-QUANT) parallel design with five work packages. WP1 - two evidence syntheses (one realist); WP2 - cross-sectional survey of routine staffing and rated quality from care home regulator; WP3 - analysis of longitudinal data from a corporate provider of staffing characteristics and quality indicators, including safety; WP4 - secondary analysis of care home regulator reports; WP5 - social network analysis of networks likely to influence quality innovation. We expressed our synthesised findings as a logic model. English care homes, with and without nursing, with various ownership structures, size and location, with varying quality ratings. Managers, residents, families and care home staff. Staffing's contribution to quality and personalised care requires: managerial and staff stability and consistency; sufficient staff to develop 'familial' relationships between staff and residents, and staff-staff reciprocity, 'knowing' residents, and skills and competence training beyond induction; supported, well-led staff seeing modelled behaviours from supervisors; autonomy to act. Outcome measures that capture the relationship between staffing and quality include: the extent to which resident needs and preferences are met and culturally appropriate; resident and family satisfaction; extent of residents living with purpose; safe care (including clinical outcomes); staff well-being and job satisfaction were important, but underacknowledged. Many of our findings stem from self-reported and routine data with known biases - such as under reporting of adverse incidents; our analysis may reflect these biases. COVID-19 required adapting our original protocol to make it feasible. Consequently, the effects of the pandemic are reflected in our research methods and findings. Our findings are based on data from a single care home operator and so may not be generalised to the wider population of care homes. Innovative and multiple methods and theory can successfully highlight the nuanced relationship between staffing and quality in care homes. Modifiable characteristics such as visible philosophies of care and high-quality training, reinforced by behavioural and relational role modelling by leaders can make the difference when sufficient amounts of consistent staff are employed. Greater staffing capacity alone is unlikely to enhance quality in a cost-effective manner. Social network analysis can help identify the right people to aid adoption and spread of quality and innovation. Future research should focus on richer, iterative, evaluative testing and development of our logic model using theoretically and empirically defensible - rather than available - inputs and outcomes. This study is registered as PROSPERO CRD42021241066 and Research Registry registration: 1062. This award was funded by the National Institute for Health and Care Research (NIHR) Health and Social Care Delivery Research programme (NIHR award ref: 15/144/29) and is published in full in Health and Social Care Delivery Research; Vol. 12, No. 8. See the NIHR Funding and Awards website for further award information.

Development Method of the Doratask Method in Its Use in Runway Capacity Calculations

Until now, Indonesia does not have its own method or a developed method for calculating runway capacity. The DORATASK method recommended by ICAO has the weakness that it can only be optimally used for single runway operations. Meanwhile, there are runway characters in Indonesia: Opposite Runway Operation, Crossing Runway Operation, Parallel Runway Operation, Staggered Parallel Runway Operation, and Low/Very Low Traffic for AFIS Airports. The aim of this research is to develop the DORATASK method so that it is compatible with runway capacity calculations with other characteristics. The method used in this research is mixed-method, with descriptive analysis categories and final results/research conclusions using ratio calculations/validity tests and formulas for new methods taken from main parameters, velocity and Pythagoras. The results of the validity test between the DORATASK method and the new method were obtained at the four airports, namely Soekarno Hatta Airport with the DORATASK method = 107 movements/hour and with the new method = 148 movements/hour, Budiarto Airport with the DORATASK method = 39 movements/hour and with the new method = 48 movements/hour, Ende Airport with the DORATASK method = 1 movement/hour and with the new method = 11 movements/hour, Rokot Airport with the DORATASK method = no results obtained and with the new method = 4 movements/hour. The principles and parameters used in the DORATASK method are still used, but are developed in the Aircraft mix, Runway Occupancy Time and Separation parameters.

Task Allocation of Multi-Machine Collaborative Operation for Agricultural Machinery Based on the Improved Fireworks Algorithm

Currently, the multi-machine collaboration of agricultural machinery is one of the international frontiers and a topic of research interest in the field of agricultural equipment. However, the multi-machine cooperative operation of agricultural machinery is mostly limited to the research on task goal planning and cooperative path optimization of a single operation. To address the mentioned shortcomings, this study addresses the problem of multi-machine cooperative operation of fertilizer applicators in fields with different fertility and fertilizer cooperative distribution of fertilizer trucks. The research uses the task allocation method of a multi-machine cooperative operation of applying fertilizer-transporting fertilizer. First, the problems of fertilizer applicator operation and fertilizer truck fertilizer distribution are defined, and the operating time and the distribution distance are used as optimization objectives to construct functions to establish task allocation mathematical models. Second, a Chaos–Cauchy Fireworks Algorithm (CCFWA), which includes a discretized decoding method, a population initialization with a chaotic map, and a Cauchy mutation operation, is developed. Finally, the proposed algorithm is verified by tests in an actual scenario of fertilizer being applied in the test area of Jimo District, Qingdao City, Shandong Province. The results show that compared to the Fireworks Algorithm, Genetic Algorithm, and Particle Swarm Optimization, the proposed CCFWA can address the problem of falling into a local optimum while guaranteeing the convergence speed. Also, the variance of the CCFWA is reduced by more than 48% compared with the other three algorithms. The proposed method can realize multi-machine cooperative operation and precise distribution of seeds and fertilizers for multiple seeding-fertilizer applicators and fertilizer trucks.

SAT-Based Techniques for Lexicographically Smallest Finite Models

This paper proposes SAT-based techniques to calculate a specific normal form of a given finite mathematical structure (model). The normal form is obtained by permuting the domain elements so that the representation of the structure is lexicographically smallest possible. Such a normal form is of interest to mathematicians as it enables easy cataloging of algebraic structures. In particular, two structures are isomorphic precisely when their normal forms are the same. This form is also natural to inspect as mathematicians have been using it routinely for many decades. We develop a novel approach where a SAT solver is used in a black-box fashion to compute the smallest representative. The approach constructs the representative gradually and searches the space of possible isomorphisms, requiring a small number of variables. However, the approach may lead to a large number of SAT calls and therefore we devise propagation techniques to reduce this number. The paper focuses on finite structures with a single binary operation (encompassing groups, semigroups, etc.). However, the approach is generalizable to arbitrary finite structures. We provide an implementation of the proposed algorithm and evaluate it on a variety of algebraic structures.

The associative pattern classifier: Progress in theoretical understanding

The Associative Pattern Classifier (APC) was designed as an associative memory, focusing particularly on pattern classification. This implies that the training memory is constructed in a single operation and pattern classification also occurs in a single process. It is important to note that the APC translates the input patterns through a translation vector, which represents the average of all input patterns. Until now, there is no theoretical framework to explain the inner workings of the APC. Its relevance is inferred from the fact that several studies have been conducted using it as a foundation. This paper seeks to provide a theoretical comprehension of the APC’s operation to facilitate future enhancements. We found the APC creates a system in static equilibrium through concurrent vectors at the origin (translation vector), resulting in a balanced separation of patterns. However, the APC cannot achieve complete pattern separation because of the presence of a neutral region. The neutral region is defined by all the points that define the separation hyperplanes. The points over the hyperplanes cannot be classified by the APC. Additionally, we discovered that the APC is unable to accurately classify the translation vector, which could be included as part of the input patterns. Our previous research showed that the APC is unsuccessful in achieving the linear separation of the AND function. In this research, we broaden the examination of the AND function to illustrate that achieving linear separation is not feasible because the separation line represents a neutral region. The APC demonstrated exceptional performance when tested with artificial datasets where patterns were distributed over balanced regions, thus operating as an efficient multiclass and non-linear classifier. Nevertheless, the performance of the APC is lower when tested with real-world databases, making the APC inaccurate due to its restricted inner workings.

Abstract 5376: Quantitative profiling of HLA class I and class II antigens and neoantigens in tissue biopsy and PBMC samples using an optimized mass spectrometry-based workflow

Abstract Major histocompatibility complex (MHC) molecules play a central role in orchestrating immune responses by presenting antigenic peptides derived from both self and foreign proteins. In the context of cancer, understanding the repertoire of tumor-associated antigens (TAAs) presented by MHC molecules (or HLA molecules in human) is crucial for deciphering how the immune system recognizes and responds to malignant cells. The identification of neoantigens, unique to individual tumors due to somatic mutations, has become a focal point in immunopeptidomic studies. One significant hurdle in systematic immunopeptidomics analysis is the high input material requirement. Here, we present a semi-automated workflow to robustly identify and quantify immunopeptides from reduced amounts of clinical tissue biopsy and peripheral blood mononuclear cell samples. At the core of immunopeptidomics is the enrichment of HLA-associated peptides, followed by identification using mass spectrometry and bioinformatics tools. We optimized the native lysis and a sequential immunoprecipitation workflow for both class I and class II immunopeptides while ensuring scalability and reproducibility. Leveraging the magnetic properties of the beads, 1,000 samples can be processed within a week by a single operator. For both tissue and PBMC samples, we performed a systematic ramping experiment starting with as little as 2.5mg tissue or 5 million PBMCs. In all experiments, The established sample preparation offers high reproducibility and identifications of good quality: 1) Class-I immunopeptides: &amp;gt;60% of the peptides identified are 9-mers, &amp;gt;80% predicted strong binders, and the expected amino acids are enriched at the anchor positions; 2) Class-II immunopeptides, &amp;gt;50% of the peptides identified are 14-to-16-mers, and &amp;gt;50% are predicted strong binders. Furthermore, the pipeline is highly sensitive as we could still identify over 2,800 class-I immunopeptides when processing 2.5 mg fresh frozen tissue and 2,000 - 3,000 class-I immunopeptides when starting from 5 million PBMCs. Furthermore, the developed immunopeptidomics workflow was deployed to profile a cohort of 12 cancerous and matched healthy lung tissue samples. Their Class-I immunopeptidomes clearly displayed a pattern where matched tissues from each subject cluster together, further underlining the fact that the intricate immune-tumor interface is highly personalized. Overall, we established a robust pipeline for for class-I and II immunopeptidome profiling from clinically relevant sample types. Taking advantage of the nature of mass spectrometry-based methods, customized targeted assays can be developed without the need for affinity reagent, allowing specific and absolute quantification of any immunopeptide of interest. Citation Format: Ilja E. Shapiro, Marco Tognetti, Tikira Temu, Oliver M. Bernhardt, Daniel Redfern, Yuehan Feng, Roland Bruderer, Lukas Reiter. Quantitative profiling of HLA class I and class II antigens and neoantigens in tissue biopsy and PBMC samples using an optimized mass spectrometry-based workflow [abstract]. In: Proceedings of the American Association for Cancer Research Annual Meeting 2024; Part 1 (Regular Abstracts); 2024 Apr 5-10; San Diego, CA. Philadelphia (PA): AACR; Cancer Res 2024;84(6_Suppl):Abstract nr 5376.

Surgical and Fertility Outcomes of Reduced-Port Robotic Myomectomy: A Single-Center Experience of 401 Cases.

Background: Reduced-port robotic myomectomy (RPRM) using Da Vinci® Xi™ is a good fertility-saving surgical option, but the surgical and fertility outcomes are unknown. Methods: This was a retrospective cohort study evaluating the feasibility of RPRM in an academic tertiary hospital setting. A total of 401 patients who underwent RPRM by a single operator between October 2017 and October 2021 were included. For RPRM, three ports are required: a 1.5 cm umbilical incision and two 0.8 cm incisions 8 cm lateral to the umbilicus. A single-port system was applied through the umbilicus, which also functioned as a working port. Unlike conventional robotic surgery, only three robot arms were utilized for the entire surgical procedure. Results: Surgical and fertility outcomes were assessed through medical records review and follow-up telephone contact. The mean age of patients at the time of surgery was 39.7 ± 6.0 years. The most common indication for surgery was menorrhagia (n = 128, 31.9%). The average number of myomas removed was 4.7 ± 4.1 (1-22), and the size was 7.8 ± 2.5 cm (2.5-16.0). The mean operation time was 103.7 ± 45.6 min. Postoperative complications were found in 9.7% (n = 39) of patients; the most common complication was transfusion (7.7%, n = 31). After surgery, 70 patients tried to conceive, and 56 became pregnant naturally or by assisted reproduction (56/70, 80.0%). The mean interval time from operation to conception was 13.5 ± 10.1 months. Among 56 who conceived, 44 gave birth (62.9%), five were still ongoing (7.1%), and seven had miscarriages (10.0%). Cesarean section was performed for most cases (43/44, 97.7%). Eight patients had obstetric complications (16.3%), but no uterine rupture was reported. Conclusions: RPRM, which provides the benefits of conventional robotic surgery along with favorable obstetric and cosmetic results, is a feasible option for patients with symptomatic uterine myomas who wish to conceive in the future.

Effect of simulation-based training workshop on obstetric emergency team collaboration and communication: a mixed study.

To explore the effects of simulation-based midwife training workshops and determine whether such a program can improve team collaboration and communication. Simulation training improves communication, team cooperation, critical thinking, and situational awareness. This mixed study was conducted September 15-18, 2021. Participants included 23 obstetricians and midwives who completed 2 days of simulation training, including communication, skills, teamwork, single technical operation, and scene running. The Clinical Teamwork Scale was used before and after the comparison, and the data were analyzed using a phenomenological analytic process. The total team cooperation, transparent thinking, closed-loop communication, overall decision-making, clear responsibility, and leadership scores of the trainees were significantly higher after than before the training. The experience of attending a simulated training workshop can be divided into two themes: innovative ways of offering training and active learning. Three key themes emerged from each category: education combined with recreation; full participation in interactions; and teamwork and communication. (1) application of knowledge (2) dissemination, and (3) sublimation of knowledge. This study's findings indicated a good experience and higher team cooperation score among midwives participating in simulation-based training in China, the value of our work is to show that the researched teaching methods, although published in other contexts, are also valuable in the Chinese context, suggesting that they will pass on the methods and concepts of the simulated training to others and change the current status of classroom teaching, which is its most meaningful practical training effect. These results imply that simulation-based midwife training for obstetric emergencies is required to improve the comprehensive ability of midwives to address obstetric emergencies, thereby improving maternal clinical outcomes. Neither patients nor the public were involved in this study, and the midwives and obstetricians voluntarily participated.

Method of searching coupled optical solitons to magneto- optic waveguides having parabolic-nonlocal law of refractive index

Numerous methodologies employed for the exploration of soliton solutions within nonlinear models demonstrate considerable efficacy and efficiency in addressing individual nonlinear partial differential equations (NLPDEs). However, their efficacy diminishes when applied to interconnected NLPDEs, owing to the presence of interaction terms in the coupled equations. Consequently, deriving exact solutions for such coupled equations presents a formidable challenge. In response to this challenge, several researchers have endeavored to solve coupled equations by assuming a proportional relationship between the solution in one line and that in another line, resulting in the imposition of excessive constraints and the subsequent reduction of coupled equations to a single equation. Regrettably, this approach compromises the fidelity of the physical phenomena that these equations aim to describe. In contrast, we propose a method characterized by its simplicity and directness, providing a more authentic and insightful analytical perspective for the investigation of coupled NLPDEs. The innovation lies in its capability to simultaneously propagate different types of solitons in two lines with a single operation, while also enabling the natural emergence of analogous solitons in both systems under minimal constraints. We apply this method to scrutinize the propagation of a diverse range of novel coupled progressive solitons in magneto-optical waveguides featuring a parabolic-nonlocal law of nonlinearity and governed by coupled nonlinear Schrödinger equations. The resultant solitons, depicted through detailed 2D and 3D visualizations in figures 1–12 demonstrate a multitude of coupled soliton forms, several of which are novel in the field.

Performance of thoracic ultrasonography compared with chest radiography for the detection of rib fractures using computed tomography as a reference standard.

Although there is growing evidence that ultrasonography is superior to X-ray for rib fractures' detection, X-ray is still indicated as the most appropriate method. This has partially been attributed to a lack of studies using an appropriate reference modality. We aimed to compare the diagnostic accuracy of ultrasonography and X-ray in the detection of rib fractures, considering CT as the reference standard. Within a 2.5-year period, all consecutive patients with clinically suspected rib fracture(s) following blunt chest trauma and available posteroanterior/anteroposterior X-ray and thoracic CT were prospectively studied and planned to undergo thoracic ultrasonography, by a single operator. All imaging examinations were evaluated for cortical rib fracture(s), and their location was recorded. The cartilaginous rib portions were not assessed. CTs and X-rays were evaluated retrospectively. Concomitant thoracic/extra-thoracic injuries were assessed on CT. Comparisons were performed with the Mann-Whitney U test and Fisher's exact test. Fifty-nine patients (32 males, 27 females; mean age, 53.1 ± 16.6years) were included. CT, ultrasonography, and X-ray (40 posteroanterior/19 anteroposterior views) diagnosed 136/122/42 rib fractures in 56/54/27 patients, respectively. Ultrasonography and X-ray had sensitivity of 100%/40% and specificity of 89.7%/30.9% for rib fractures' detection. Ultrasound accuracy was 94.9% compared to 35.4% for X-rays (P < .001) in detecting individual rib fractures. Most fractures involved the 4th-9th ribs. Upper rib fractures were most commonly overlooked on ultrasonography. Thoracic cage/spine fractures and haemothorax represented the most common concomitant injuries. Ultrasonography appeared to be superior to X-ray for the detection of rib fractures with regard to a reference CT.

One‐Pot Synthesis of 2‐(Alkylsulfanyl)quinolines from Aryl Isothiocyanates and Allenes or Alkynes

AbstractIn this work, a conceptually novel approach to diversely substituted 2‐(alkylsulfanyl)quinolines is described. The approach includes the assembly of the target molecules from allenic or acetylenic carbanions, aromatic isothiocyanates, and alkylating agents. The process proceeds in a single synthetic operation via the formation and 6π‐electrocyclization of N‐aryl‐1‐aza‐1,3,4‐trienes, R2R3C=C=C(R1)C(SAlk)=NAr, with the participation of the carbon‐carbon double bond of the phenyl group and the azadiene fragment of the azatrienic system.

Comparative Evaluation of Push-Out Bond Strength of Conventional Mineral Trioxide Aggregate, Biodentine, a Modified Mineral Trioxide Aggregate, and Two Novel Antibacterial-Enhanced Mineral Trioxide Aggregates.

Background The challenges associated with incorporating antimicrobial agents, such as the potential diminishment of the cement's physical properties, highlight the need for comprehensive evaluations. Balancing antimicrobial efficacy with the maintenance of structural integrity is a crucial aspect of material development. The acknowledgment of cytotoxic properties associated with tricalcium aluminate, a major constituent in conventional mineral trioxide aggregate (MTA), is critical in terms of long-term evaluation of treatment procedures. The primary focus of the push-out test is to evaluate the resistance of the tested material to dislodgement. Greater push-out strength implies stronger adhesion between the tested material and the tooth surface. Aim This study aims to evaluate the push-out bond strength of two antibacterial-enhanced MTAs with conventional MTA and Biodentine. Material and methods A total of five materials were tested: a) modified MTA, b) doxycycline-enhanced MTA, c) metronidazole-enhanced MTA, d) conventional MTA, and e) Biodentine. All the materials were mixed based on a predetermined powder:liquid ratio and then carried using a plastic instrument to the desired experimental design. Single-rooted permanent teeth, preferably incisors, were used in the present study. Teeth were embedded vertically in a rubber mold, and sectioning of the tooth was performed. A single operator instrumented the canal space in each slice using Gates-Glidden burs, and the mixed cements were placed in the respective groups and stored for 72 hours. A push-out test was carried out using a universal testing machine. Following the bond failure, the slices were examined under a stereomicroscope to determine the nature of the bond failure. The collected data was subjected to a one-way analysis of variance test, post hoc test, and chi-square test for statistical analysis. Results The mean push-out bond strength was found to be the highest for Biodentine (43.25 ± 0.62 megapascals (MPa)), followed by doxycycline- and metronidazole-enhanced MTAs (39.54 ± 0.65 MPa and 39.29 ± 0.16 MPa, respectively), modified MTA formulation (37.75 ± 0.73 MPa), and the lowest for conventional MTA (25.93 ± 0.7 MPa). Conventional MTA samples had an adhesive failure (89.4%), while Biodentine samples had a cohesive failure (80.3%). Mixed failures were noticed with the samples containing modified MTA formulation (71.3%), doxycycline-enhanced MTA (76.6%), and metronidazole-enhanced MTA (78.0%). Conclusion Despite not surpassing Biodentine in bond strength, antibacterial-enhanced MTAs are considered potential alternatives to conventional MTA in day-to-day clinical practice.