Pairwise Comparison Tests Research Articles

Features of damage to the central nervous system and mental sphere in patients with comorbid post-COVID syndrome

The prevalence of post-COVID syndrome in patients treated on an outpatient basis ranges from 10 to 35 %; it can reach 80 % in patients with severe coronavirus infection. It is currently hypothesized that long-COVID may be due to both the direct effects of the SARS-CoV-2 virus and the biopsychosocial effects of COVID-19.The aim. To study the characteristics of damage to the central nervous system and mental sphere in patients with comorbid post-COVID syndrome.Materials and methods. To study the clinical features of the course of post-COVID syndrome, 98 patients who had suffered COVID-19 were examined. Of these, 18 (18.4 %) were men, 80 (81.6 %) were women. The mean age in the group was 56.05 ± 1.27 years. The examination program included a questionnaire, clinical examination, pulse oximetry, and assessment of exercise tolerance using the Borg scale. Statistical processing was carried out using the Statistica software package, version 6 (StatSoft Inc., USA). The results of the study are presented as a median, upper and lower quartiles. After analyzing the compliance of the studied indicators with the law of normal distribution (Shapiro – Wilk test), the groups were compared using the Wilcoxon test for pairwise comparison of related samples. Differences were considered statistically significant at p < 0.05.Results. Our studies of comorbidity and complications after COVID-19 infection revealed the most frequent involvement of three systems in the pathological process: cardiovascular, nervous and endocrine. Metabolic syndrome was detected in 67 % and involvement of the cardiovascular system was detected in 48.8 % of those examined.One of the main manifestations of post-COVID syndrome is damage to the central nervous system and mental sphere in the form of mild cognitive and emotional-volitional disorders with asthenodepressive and anxiety-depressive disorders.Conclusion. The health status of patients after COVID-19 is significantly lower than that of the general population. The study results indicate an urgent need to study the pathogenesis of long COVID and develop effective interventions to reduce the risk of its development.

Knowledge Level of Physicians Prescribing Bisphosphonates: Prevention and Treatment of Medication-Related Osteonecrosis of the Jaw

Introduction: Medication-related osteonecrosis of the jaw (MRONJ) is an important uncommon complication. Due to its complexity, its prevention requires a multidisciplinary approach, involving physicians and dental clinicians. Materials and Methods: This study aimed to assess the knowledge level of physicians prescribing bisphosphonates in Tehran, Iran, about dental considerations in such patients and the prevention and treatment of MRONJ in 2019. This descriptive, cross-sectional study evaluated 100 physicians (rheumatologists, endocrinologists, oncologists, and orthopedists) practicing in Tehran. A questionnaire comprising a demographic section and knowledge questions regarding dental considerations in patients taking bisphosphonates was administered among the physicians. The frequency of qualitative variables such as gender, type of specialty, and physicians’ responses to each question was calculated, and the knowledge scores were analyzed separately based on the physicians’ specialty types using one-way ANOVA followed by Tukey’s test for pairwise comparisons. The effect of different variables on knowledge scores was analyzed by simple regression. Results: The mean knowledge score of physicians was 5.19±1.78 (range 2-8). The mean knowledge score of oncologists was significantly higher than that of endocrinologists (5.88 versus 4.52, P=0.03). No other significant differences were noted. Work experience (P=0.04), age (P=0.02), orthopedics specialty (P=0.05), and oncology specialty (P=0.006) had significant effects on the knowledge score. Conclusion: Considering acquiring about 50% of the total score, physicians seem to have limited knowledge about dental considerations in patients taking bisphosphonates.

Effect of Salvadora persica chewing sticks on maxillary central incisors crown-root angulation in Western-Asian population & correlation with Collum angle on 3D CBCT images

The main aim of the study was to identify the Collum angle classification for maxillary central incisors among individuals use vs not-use chewing sticks which could have beneficial role for immediate implant placement in respective individuals. Additionally, to identify the root-crown positioning and angulation in the Western Asian Saudi Arabian population for chewing sticks user’s vs non-users in order to develop guideline for the prosthetic procedures using Cone beam computed tompography (CBCT). A total number of 380 CBCT scans were included in the study for both of the groups based on the inclusion criterion of the patients reporting to the Dental OPD of Riyadh Elm University. The data was analyzed using 3D planner dental imaging software. Initially the teeth were classified based on root position in relation to facial plate of alveolar bone using Jung et al. classification. Additionally, the Collum angle and the root angulation of the maxillary central incisors was evaluated. The data was analyzed using one-way Anova with post-hoc Tuckey-Kramer test for pair-wise comparison. As per the Jung et al. classification, majority of the roots were observed with buccal placement. Based on the Collum angle classification majority of the maxillary central incisors were observed with facial placement (n=170), specially subtype I (n=78). But the root angulation was observed to be independent of Collum angle. Thus, it can be concluded, unlike root angulation, Collum angle has a correlation with root positioning. The angle for the individuals using chewing sticks of Salvadora Persica was similar to the individuals not using the miswak. Collum angle is correlated in all classified position of root. But the root angulation is independent of classification varies between miswak and non-miswak users.

Benefits of an educational intervention on functional capacity in community-dwelling older adults with frailty phenotype: A randomized controlled trial

BackgroundThere is an urgent demand for nurses to expand their knowledge and skills in managing frailty in primary care. Frailty is a multifaceted condition that is prevalent among older adults and often leads to reduced functional capacity. Currently, there is a limited understanding of the effectiveness of educational interventions aimed at improving functional capacity among community-dwelling frail older adults in a primary care setting. ObjectiveThis study aimed to evaluate the impact of an educational program on functional capacity among pre-frail and frail older adults living in the community. DesignA 12-month, multicenter, randomized controlled trial. SettingsThe FRAGSALUD study was conducted across 14 healthcare centers situated within the regions of Cadiz and Malaga, Spain. ParticipantsA total of 199 frail/pre-frail community-dwelling older adults (74.2 ± 6.4 years). MethodsParticipants who met at least one Fried's criteria were assigned to either the control group (n = 90), which received usual healthcare assistance, or the intervention group (n = 109). The 6-month intervention comprised four group sessions and six telephone calls conducted by professional nurses, sport scientists, and nutritionists. This educational program focused on guidelines for physical activity, nutritional habits, cognition, and psychosocial well-being. Functional capacity was assessed using questionnaires for basic (Barthel Index) and instrumental (Lawton & Brody Scale) activities of daily living. All outcome measures were evaluated at baseline, immediately after the intervention (6-month), and six months after the intervention as a follow-up (12-month). Differences in functional capacity (Barthel Index and Lawton and Brody Scale scores) across the three time points were analyzed using Friedman's ANOVA, with Wilcoxon signed-rank test for pairwise comparisons. ResultsAt both 6-month and 12-month assessments, the control group showed a statistically significant decline in basic and instrumental activities of daily living compared to the intervention group, which maintained similar levels, preventing this age-related decline. ConclusionsThe educational intervention, designed for easy implementation within healthcare systems, especially for nurses, successfully maintained levels of functional capacity in basic and instrumental activities of daily living, while the control group experienced a decline in functional capacity during the 12-month follow-up. Thus, educational interventions are encouraged for preserving the functional independence of frail/pre-frail older adults living in the community. RegistrationThis trial was registered at ClinicalTrials.gov (Identifier: NCT05610605) and the first participant was registered in March 2022.Tweetable abstract: The FRAGSALUD educational intervention prevents the age-related decline in functional independence over 12 months in frail older adults.

Adaptive stereotactic radiosurgery for cerebral metastases of non-small cell lung cancer: a retrospective study

INTRODUCTION: Non-small cell lung cancer (NSCLC) is a common cause of brain metastases (BM). Adaptive stereotactic radiosurgery (ASRS) may be a useful option in the treatment of patients with large unresectable brain metastases (BM), but to date there are only a limited number of studies evaluating the effectiveness of this method.OBJECTIVE: To analyze the effectiveness of ASRS in patients with large BM NSCLC not subject to surgical resection.MATERIAL AND METHODS: We retrospectively analyzed data from 37 patients suffering from NSCLC with 45 large (>2 cm in diameter, volume >4 cm3) unresectable BM treated with the Gamma Knife Perfexion model using two- and three-fraction ASRS. Of these, 14 foci (31.1%) were metastases of squamous cell lung cancer, 31 (68.9%) were metastases of adenocarcinoma. The median volume of lesions treated with ASRS was 9.8 (range 4.6–30.6 cm3). The dynamics of volume changes between fractions and the cumulative incidence of local relapses (CILR) were studied, and ROC analysis was performed for the tumor volume parameter. Intracranial progression-free survival (iPFS) and overall survival (OS) were assessed. Statistics: To establish statistical significance of differences for related variables, the Wilcoxon test for pairwise comparisons and the Friedman test for three or more groups were used. The Kaplan-Meier method was used to calculate local control, PFS, and OS rates. The log-rank test was used to compare survival data in two groups.RESULTS: The median follow-up period was 19.4 months. With two-fraction ASRS, the median volume of metastasis decreased by 28.6% by the second session, with three-fraction — by 40.0% by the third session. The 1-year and 2-year CILR rates were 8.6±6.1%, respectively; 26.1±12.3%. In ROC analysis, the area under the curve (AUC) for tumor volume was 0.80 (95% CI 0.6– 1.0) with an optimal cutoff of 18.5 cm3. The differences in CILR between the groups with metastasis volume <18.5 cm3 and ≥18.5 cm3 were statistically significant (p<0.001). Median iPFS was 8.3 (95% CI 5.9–10.7) months, 1-year iPFS was 33.5±8.1%;2-year — 7.8±5.2%. Median OS was 13.2 (95% CI 9.0–17.4) months; 1-year OS — 52.9±8.7%, 2-year — 22.4±8.8%.DISCUSSION: Using two- and three-fraction ASRS, we delivered doses to large BM sufficient for a high level of local control with an acceptable risk of neurotoxicity: 1-year local control was 91.4%; 2-year — 73.9%; the incidence of radionecrosis is 8.5%. A statistically significant effect of lesion volume ≥18.5 cm3 on the risk of local recurrence was found. The iPFS and OS indicators after ASRS can be considered satisfactory for this group of patients.CONCLUSION: ASRS is an effective and perhaps optimal strategy for the treatment of large unresectable BM in patients with NSCLC, but comparison with other modern radiotherapy modalities such as stereotactic hypofractionated radiotherapy and WBRT with simultaneous integrated boost is needed.

Impact of slouching on heart rate variability and cardiovascular health among medical students

Background: Medical students frequently adopt poor postures such as slouching potentially impacting health. Heart rate variability (HRV) serves as an indicator of autonomic nervous system function, correlated with cardiovascular health. Aims and Objectives: The objective of the study was to compare HRV parameters among medical students in three postures: Sitting erect, easy pose (cross-legged), and slouching (stooping head and shoulders). Materials and Methods: A comparative cross-sectional study enrolled 26 male medical students. Participants were instructed to maintain each posture for 5 min while HRV was recorded using a Polar V800. Time domain and frequency domain parameters among different postures were analyzed using Friedman’s test and post hoc tests for pairwise comparisons. P<0.05 was considered significant. Data were expressed as median interquartile range. Results: Significant differences were observed in HRV parameters between postures. The easy pose demonstrated a significantly higher median value of root mean square of differences of successive RR intervals (48.28 ms vs. 35.35 ms) and pNN50% (24.40% vs. 13.62%) compared to slouching. Frequency domain analysis revealed a significantly higher median value of high-frequency (HF) power in easy pose (626.56 ms² vs. 378.15 ms²) and HF normalized unit (33.78 vs. 22.55) compared to slouching. A lower low frequency (LF)/HF ratio and (1.96 vs. 3.43) lower LF normalized unit (66.18 vs. 77.30) was also seen in easy pose. Although statistically not significant, the parasympathetic indicators of HRV were higher in erect sitting compared to slouching posture. Conclusion: Among medical students, adopting the easy pose (cross-legged sitting) appeared to enhance HRV and thus increase parasympathetic activity, whereas adopting slouching postures decreased it.

Comparative 3D Analysis of Lip Rejuvenation: Investigating Effects Before and After Soft-Tissue Filler Compared with Controls.

The aim of this study was to evaluate changes in lip metrics before and after facial rejuvenation treatment with hyaluronic acid-based fillers and to compare them with those of a control group using stereophotogrammetry (3D). This study included 63 Caucasian women divided into Group C (<30years, n=30) and Group H (>30years, n=33), which was further divided into before (HT0) and after (HT1) lip augmentation with hyaluronic acid (HA). Eleven anthropometric landmarks were identified for linear, angular, and surface area measurements. Three photos were captured in Group C, while Group H had photos taken at T0 and T1. Statistical analysis was conducted using the Shapiro-Wilk test to evaluate normality, the Kruskal-Wallis test and one-way ANOVA. Tukey's post hoc and pairwise comparison tests were performed to analyze differences between variables (P value < 0.05). There were significant differences between lip width (ChR-ChL) and philtrum width (CphR-CphL) (P<.001). The total heights of the upper (Ls-Li) and lower vermilion lips (Sto-Li) increased, and the heights of the upper (Sn-Ls) and lower (Li-Sl) cutaneous lips decreased. The angles related to the philtrum (ChR-CphR-Ls, P<.001; ChL-CphL-Ls, P<.001) and nasolabial angle (Prn-Sn-Ls) (P<.001) exhibited significant differences. The surface areas of the upper, lower, and total vermilion lip showed significant differences (P<.001). Tukey's test indicated no significant differences in surface area after lip augmentation between the HT1 and C groups. Analysis of lip morphology after a filler procedure revealed a reversal of age-related changes, with increases in vermilion lip height and surface area comparable to those of younger individuals. This journal requires that authors assign a level of evidence to each article. For a full description of these Evidence-Based Medicine ratings, please refer to the Table of Contents or the online Instructions to Authors www.springer.com/00266 .

Evalution of shear bond strength of brackets bonded using different hydrophobic and hydrophilic adhesives: An invitro study

A review of the long history of orthodontic bonding adhesives shows that many evolutional developments have occurred from the first chemically-cured composite resins to the most recently introduced light-cured color-change adhesives. An ideal orthodontic adhesive should have adequate bond strength while maintaining unblemished enamel after debonding. Therefore, researchers have been working hard to achieve the best quality and gentlest materials for bonding orthodontic brackets.To evaluate the shear bond strength of brackets bonded using four different adhesives in both dry and in moist environment.A total of 80 orthodontically extracted premolars will be selected. They are divided into 4 equal groups of different adhesives which are further sub-divided into 2 group each (dry and in presence of moisture). All the selected teeth will be cleaned and store in saline until it use. All teeth will be mounted on acrylic block. The shear bond strength will be measured by Lloyd’s Universal testing machine. The obtained data will be statistically evaluated using SPSS22 for Windows using ANOVA test at statistical significance.: The shear bond strength of the four groups were tested with Instron universal testing machine; breaking load at which bond failure occurred was recorded and bond strength was calculated. Data obtained was compiled on MS Office Excel Sheet (2007, Microsoft Redmond Campus, Redmond. Washington, United States.)Data was subjected to statistical package for social sciences (SPSS v 21).Statistically significant difference seen between the hydrophobic and hydrophilic adhesives. In the present study we did Tukey’s post hoc test for pairwise comparison of different hydrophobic and hydrophilic adhesives. It show highly significant values. : The greatest bond strength values were achieved with TransbondXT in both dry and saliva contamination condition. These values were significantly greater than those achieved with Greengloo, RMGIC and Aqualine LC. The overall study conclude that TransbondXT was considered the feasible adhesive material for orthodontic bonding followed by Aqualine LC.

The Efficiency of Different Supplementary Irrigation Techniques After Nickel-Titanium Rotary System in Endodontic Retreatment

Objective: To assess the efficiency of XP-Endo Finisher file (XPFF), EDDY, and diode laser as supplementary irrigation activation techniques following nickel-titanium rotary files in the endodontic retreatment. Methods: 48 mandibular premolars were collected. Each root canal was shaped and filled with EndoSequence BC sealer and gutta percha. After 14 days, endodontic retreatment was performed using D-Race instruments. Then, 48 samples were assigned into 4 groups (n=12) as control, diode laser, EDDY, and XPFF according to the supplementary irrigation methods. After the irrigation procedure, all samples were visualized under a stereomicroscope. The remaining root filling material was scored and compared statistically using Kruskal-Wallis and Post-hoc pairwise comparison tests. Results: In all thirds, there was a significant difference between the diode laser and control groups. The amount of remaining filling material in the diode laser group was significantly lower than in the control group. When the other groups were compared, a significant difference was observed only between the diode laser and XPFF groups in the coronal third. Conclusion: No supplemental method could eliminate the root obturation material. The diode laser can be used in addition to nickel-titanium rotary retreatment systems to improve the removal of gutta percha and bioceramic sealer.

A comparison of factor models in China

We evaluate the performance of eleven asset pricing models in the Chinese A-share market using a variety of test portfolios and statistical methodologies. To compile the test portfolios, we construct 105 anomalies and use the 23 significant anomalies as test assets for model comparison. The results indicate that, in time-series test and anomaly explanations, the Hou et al. (2019) five-factor q model demonstrates the best overall performance. The pairwise cross-sectional R2 tests and multiple model comparison tests further affirm that the Hou et al. (2019) five-factor q model, the Fama and French (2018) six-factor (FF6) model, and the Kelly et al. (2019) five-factor Instrumented Principal Component Analysis (IPCA5) model are the top performers. Notably, the performance of the five-factor q model remains robust across various experimental designs.

A new method of intraoperative assessment of the dynamics of cortical blood flow using imaging photoplethysmography

Background. Intraoperative assessment of changes in cerebral blood flow is an important component of objective quality control of surgical treatment of cerebral artery aneurysms. Various techniques have been tried to solve this task, but they all have their drawbacks, which forces us to look for new ways of blood flow monitoring. We propose to use the technology of imaging photoplethysmography (IPPG) – a technically simple, contactless, safe and cheap optical method for assessing the perfusion of biological tissues.Aim. To demonstrate the possibility of using IPPG to assess the dynamics of cerebral blood flow parameters during aneurysm clipping surgery, as well as to identify early changes in blood supply to the cerebral cortex.Materials and methods. The study was carried out during six surgeries of clipping aneurysms of the anterior part of the Willis’s circle, both in the acute stage of rupture (n = 1) and in a planned manner (n = 5). The IPPG system, which is an LED illuminator in a single unit with a digital video camera, was located on a tripod 25 cm from the intervention zone. During each operation, two one-minute recordings of the illuminated surface of the cerebral cortex were performed: after dissection of the dura mater and before its suturing at the end of the main stage of the intervention. To improve the measurement accuracy, video frames of the studied area were recorded synchronously with the registration of an electrocardiogram. After recording, two IPPG parameters were calculated and compared: the amplitude of the pulsatile component and the pulse wave transit time. Thereafter, the obtained data were compared with the results of computed tomography. Statistical analysis was performed using pairwise comparison tests in the GraphPad Prism software package.Results. Clipping of cerebral vessel aneurysms are accompanied by significant changes in the parameters of cerebral blood flow. Analysis of the data for all patients revealed significant differences in IPPG parameters before and after surgery, namely, statistically significant increase in amplitude of the pulsatile component (n = 3) and decrease in pulse wave transit time (n = 5). The absence of significant changes in both parameters was found only in one patient who had mechanical damage in the cortex in the region of video recording.Conclusion. The IPPG system is capable to quantify changes in blood supply to the cortex during surgical treatment of cerebral artery aneurysms and to identify areas with either increased or decreased blood supply. In-depth studies are required to obtain additional markers of the postoperative state of cerebral blood flow.

Three-dimensional assessment of the nasopharyngeal airway in Down syndrome during the mixed dentition period: a case-control study.

In this retrospective case-control study, we aimed to evaluate the nasopharyngeal airway volume of children with Down syndrome (DS) and compare the results with those of control participants well matched for sex and age. Fifteen children with DS (mean age = 9.43 ± 0.38 years; 8 boys, 7 girls) and 15 control participants (mean age = 9.51 ± 0.40 years; 8 boys, 7 girls) were enrolled. The nasopharyngeal airway volume and the cross-sectional morphology were measured with cone-beam computed tomography taken for orthodontic treatment. All measurements were assessed by analysis of covariance (ANCOVA) using Bonferroni post hoc pairwise comparison tests. Covariates were body height and body weight, and the ANB angle and the mandibular plane angle. Significance was set at P < .0019. Nasal airway, superior airway, and total airway volumes of DS participants were significantly smaller than those of the control participants in ANCOVA results adjusted for ANB angle and mandibular plane angle (P = .000). In ANCOVA results adjusted for body height and body weight, no statistically significant differences in the volume measurements were found. The results indicate that the nasopharyngeal airway volume differs between children with and without DS and that the airway volume tends to be smaller in DS children than in children without DS.

The impact of various substrates, ceramic shades, and brands on the ultimate color and masking capacity of highly translucent monolithic zirconia: an in vitro study.

This study aimed to examine the impact of substrates, ceramic shades, and brands on the color and masking ability of highly translucent monolithic zirconia (HTMZ) using CIELab and CIEΔE2000 metrics. A total of 156 1-mm thick HTMZ disks in shades A1, A2, and A3 were produced using Dental Direkt and Kerox zirconia brands. Four 3-mm thick substrates (nickel-chromium alloy, non-precious gold alloy (NPG), zirconia shade A2, and resin composite shade A2) were prepared. HTMZ disks were overlaid on these substrates, and color measurements were taken with a spectrophotometer. Color differences (ΔE) were analyzed using CIELab and CIEΔE2000 formulas. The influence of brand, shade, substrate, and their interactions on ΔE values was assessed with a General Linear Model (GLM) and LSD pairwise comparison test. Spearman's correlation test examined the relationship between CIELab and CIEΔE2000 values. Results indicated that ΔEab was significantly influenced by substrate type and shade, while ΔE2000 was also affected by the ceramic brand. Mean color differences across ceramic-substrate groups were within clinically acceptable and perceptible ranges (clinically perceptible: ∆Eab ≥ 1.3 and ∆E2000 ≥ 0.8; clinically acceptable: 0.8 < ∆E2000 ≤ 1.8 and 1.3 < ∆Eab ≤ 2.7), except for NPG, which had ΔE values exceeding the perceptible range (ΔE2000: 1.1 ± 0.11 to 1.8 ± 0.31; ΔEab: 1.61 ± 0.15 to 2.16 ± 0.36). A significant correlation (r = 0.974, P < 0.001) was found between ΔEab and ΔE2000. Various ceramic brands and shades led to notable ΔE variations, yet average color differences within all ceramic-substrate groups remained clinically acceptable. Both ΔEab and ΔE2000 were reliable methods with a strong correlation for measuring color differences.

Enhancing Physical Fitness in Elite Field Hockey Players with A Twelve-Week Functional Training Program: A Cluster Randomized Control Trial.

This study aimed to explore the impact of functional training on the physical fitness of young elite field hockey players. The study comprised 40 young elite male field hockey players with the following characteristics (mean ± SD age: 21.5 ± 0.8 years; height: 176.9 ± 2.6 cm; weight: 68.4 ± 5.1 kg; BMI: 21.8 ± 1.3; training experience: 51.2 ± 5.4 months). Twenty participants were allocated to two groups: the functional training group (FTG) and the control training group (CG). Each group received 60-minute training sessions three times per week for 12 weeks. Generalized estimating equation analysis and a Bonferroni test for pairwise comparisons were used to assess the intervention's efficacy. Before the start of the exercise program, no statistically significant differences were observed in physical fitness measures between the FTG and CG (p > 0.05). However, by the sixth week, a significant difference appeared in both the T-Agility test (p < 0.001) and endurance (p = 0.024) between the two groups, while no notable distinctions were detected in other fitness parameters (p > 0.05). After a 12-week training program, the FTG demonstrated improvements in all physical fitness measures [flexibility (p < 0.001); Illinois agility test (p < 0.001); T-agility test (p = 0.020); endurance (p < 0.001)] except speed, which exhibited no significant impact (p = 0.175). Notable enhancements in T-agility and endurance were evident after just six weeks of functional training, and a 12-week functional training regimen showed superiority over standard training approaches in young elite male field hockey players. These findings encourage the efficacy of functional training exercises over traditional methods in enhancing athletes' fitness parameters.

The Impact of Orthodontic Adhesive Containing Resveratrol, Silver, and Zinc Oxide Nanoparticles on Shear Bond Strength: An In Vitro Study.

Introduction The goal of orthodontic treatment is to provide patients with esthetic smiles and functional occlusion. Despite best efforts and continuous evolution of materials, white spot lesions present a persistent hindrance to the desired treatment outcome. Nanoparticles have shown efficacy in reducing microbial activity; however, currently, there is a need for natural anti-cariogenic compounds with minimal side effects. Resveratrol is a natural compound belonging to the polyphenol group and has shown promising anti-microbial efficacy. This study aimed to evaluate the influence of dentin bonding agentsincorporated with the following three different nanoparticles on shear bond strength: silver nanoparticles (Ag-Np), zinc oxidenanoparticles (ZnO-Np), and resveratrol nanoparticles (RSV-Np). Materials and methods A total of 40 premolar teeth therapeutically extracted were assigned to four equal groups of n=10 each. Groups 1, 2, and 3 used experimental adhesivesdoped withsilver, zinc oxide, and resveratrol nanoparticles, respectively. Group 4 was bonded using unmodified adhesive. The bonded teeth were then subjected to shear bond strength (SBS) testing which was measured using a Universal Testing Machine (model no. UNITEST-10; Pune, India: ACME Engineers).Statistical analyses were performed using SPSS version 21 (Armonk, NY: IBM Corp.), employing one-way ANOVA and Tukey's post-hoc test for pairwise comparisons. Results Shear bond strength testing revealed that the control group with unmodified adhesive (8.6 MPa) had the highest SBS, followed by RSV-Np (7.6 MPa), Ag-Np (6.3 MPa), and ZnO-Np (5.65 MPa). Although the experimental groups demonstrated decreased SBS compared to the control, the values for Ag-Np and RSV-Np fell within the acceptable range. Conclusion Resveratrol nanoparticleshad the least impact on shear bond strength among the experimental groups. These findings suggest that the incorporation of resveratrol nanoparticles in dentin bonding agents can provide anti-cariogenic effect without significantly impacting the adhesive's mechanical properties thereby providing a new and promising alternative to synthetic nanoparticles. Further studies are recommended to optimize the balance between anti-microbial efficacy and bond strength in clinical applications.

Nontechnical Skills Assessment in Acute Care Trauma Simulations: A Mixed Methods Approach Using Eye Tracking and Behavioral Marker Systems.

The condition of trauma patients and the urgent need for timely resuscitation present unique challenges to trauma teams. These difficulties are exacerbated for military trauma teams in combat environments. Consequently, there is a need for continued improvement of nontechnical skills (NTS) training for trauma teams. However, current approaches to NTS assessment rely on subjective ratings, which can introduce bias. Accordingly, objective methods of NTS evaluation are needed. Eye-tracking (ET) methods have been applied to studying communication, situation awareness, and leadership in many health care settings, and could be applied to studying physicians' NTS during trauma situations. In this study, we aimed to assess the relationship between trauma team leaders' objective gaze patterns and subjective expert NTS ratings during patient care simulations. After Institutional Review Board approval, 9 trauma teams from first-year post-graduate general surgery and emergency medicine residents were recruited to participate in 1 of 2 trauma simulations (a difficult airway case and a multi-patient trauma). Each scenario lasted approximately 15 minutes. All team leaders wore a mobile ET system to evaluate gaze metrics-time to first fixation (TTFF), average fixation duration (AFD), and total percentage of the scenario (TPS) focused on Areas of Interest (AOI), which included patient, care team, diagnostic equipment, and patient care equipment. Trained faculty raters completed the Non-Technical Skills for Surgeons (NOTSS) assessment tool and the Trauma Non-Technical Skills (T-NOTECHS) scale. One-way analysis of variance, Kruskal-Wallis, and appropriate post-hoc pairwise comparison tests were run to assess differences between ET metrics across AOI groups. Spearman's Rho tests were used to assess correlations between ET and subjective NTS ratings. Compared to other NTS domains, trauma teams scored relatively poorly on communication across both T-NOTECHS (3.29$ \pm $0.61, maximum = 5) and NOTSS (2.87$ \pm $0.66, maximum = 4). We found significant differences in trauma team leaders' TTFF between teammates and the patient (Team: 1.56 vs Patient: 29.82 seconds, P < .001). TTFF on the diagnostic equipment was negatively correlated (P < .05) to multiple measures of subjective NTS assessments. There were no significant differences in AFD between AOIs, and AFD on teammates was positively correlated (P < .05) to communication and teamwork. There were significant differences in TPS across most AOI pairs (P < .05), and the average TPS fixated was highest on the patient (32%). Finally, there were several significant correlations between additional ET and NTS metrics. This study utilized a mixed methods approach to assess trauma team leaders' NTS in simulated acute care trauma simulations. Our results provide several objective insights into trauma team leaders' NTS behaviors during patient care simulations. Such objective insights provide a more comprehensive understanding of NTS behaviors and can be leveraged to guide NTS training of trauma physicians in the future. More studies are needed to apply these methods to capture NTS from a larger sample of teams in both simulated and real trauma environments.

Cost-sensitive stacked long short-term memory with an evolutionary framework for minority class detection

‘Minority attack detection’ is a matter of great concern while designing a secure network and safeguarding it against cyber criminals who attempt to breach its defenses, intrude into its systems, and gain unauthorized access to sensitive information. An adequate intrusion detection system is demanded to counter such threats involving class imbalance and high dimensionality in network traffic. In this context, an artificial intelligence-based multiclass framework MCGAL is presented, which leverages the evolutionary technique of genetic algorithm to achieve the finest feature selection and stacked long short-term memory (LSTM) for traffic classification. The proposed approach utilizes cost-sensitive LSTM by assigning greater significance to minority or rarely occurring classes, thereby addressing the challenge of misclassification in the presence of imbalanced data in a real web attack subset of the CSE-CIC-IDS2018 dataset. A comprehensive performance analysis is performed to evaluate our proposed scheme concerning various class metrics using weighted and macro averages, which reveals a classification accuracy of 100 %. An achieved weighted average of 1.00 is then compared with baseline classifiers like decision trees, AdaBoost, and support vector machines utilizing both linear and radial kernels. The results of MCGAL are also assessed with recently reported techniques on the same dataset demonstrating remarkable improvements in all metrics such as precision, recall, and F-score of minority class detection. A pair-wise comparison and Kruskal-Wallis test at a 95 % significance level further illustrate the statistical significance of the proposed scheme for minority class detection.

Preparedness and Anxiety of Dental Students in the Transition from Preclinical to Clinical Practice

Aim: This study aimed to investigate the preparedness and anxiety levels of dental students transitioning to clinical practice and to examine the effects of sex, university, and observations. Material and Method: A total of 182 students (58 male, 124 female) transitioning from preclinical to clinic participated in the study. The survey consisted of sections covering socio-demographic data, students' opinions on their preparedness for clinical practice, anxiety levels measured by the State-Trait Anxiety Inventory (STAI), and confidence levels in various skill areas. Spearman's Rank correlation test was used for correlation analysis, while the Mann Whitney-U test for pairwise group comparisons. Results: No differences were found in preparedness between sexes, but males exhibited significantly higher confidence in various dental skills. Conversely, females reported significantly higher levels of state and trait anxiety. State university students (n=48) reported heightened workload expectations and elevated levels of state and trait anxiety. Conversely, private university students (n=134) demonstrated increased confidence and preparedness in dental practice-related knowledge and skills. Students who participated in observations (n=96) had lower preparedness and confidence levels in several dental areas, coupled with higher trait anxiety levels, compared to their peers who did not participate in observations (n=86). Finally, STAI scores were positively correlated with workload, negatively correlated with knowledge, skills, and confidence. Conclusion: Sex, school, and observation status have an impact on students' preparedness for clinical education, anxiety, and confidence in their professional abilities. Therefore, assessments and orientation programs that take these aspects into account can benefit students at this time of change.

The Effect of Physical Activity on Quality of Life in Refugee Children

The aim of this study was to show the relationship between the quality of life and physical activity of refugee children who came to Turkey as a result of forced migration from their home countries. The study was conducted with the voluntary participation of 100 children between the ages of 14 and 17 living in the center of Çorum province in Turkey who were admitted as refugees. The data was collected by means of a questionnaire. The "Personal Information Form" created by the researchers was used in the first part and the "High School Quality of Life Scale (HSQOLS)" was used in the second part. For the selection of statistical tests, two independent group comparisons were made using the Mann Whitney U-test, as the data were not normally distributed. Comparisons between three independent groups were carried out using the Kruskal-Wallis test, as the data were not normally distributed. To determine the different groups after the Kruskal-Wallis test, the Mann Whitney U post hoc pairwise comparison test with Bonferroni correction was used. The statistical significance level was assumed to be p0.005. Statistically significant differences were found between participants' athletic status in Turkey, athletic branch in Turkey, athletic branch in their country of origin, athletic branch in their country of origin, and athletic age and the total scale and all sub-dimensions of the LISCEC (p0.05). It is therefore hypothesized that physical activity and sport positively influence the quality of life of refugee children from different cultures in the countries where they settle and that this interaction is due to the integrative function of sport.

Neuroprotective Effects of Bexarotene and Icariin in a Diabetic Rat Model.

Objective Type 2 diabetes mellitus (T2DM), a chronic metabolic disorder affecting over 400 million people globally, is increasingly recognized for its detrimental impact on the central nervous system. T2DM is linked to neurodegenerative diseases like Alzheimer's and vascular dementia. This study investigates the neuroprotective effects of bexarotene and icariin in a T2DM rat model, focusing on brain-derived neurotrophic factor (BDNF), glial fibrillary acidic protein (GFAP), and neurofilament-light chain (NfL) levels. Methods Before the study, rats underwent fasting blood glucose tests, lipid profile assessments, and general health evaluations, followed by a high-fat diet for two weeks and a single streptozotocin dose (35 mg/kg). Rats with fasting blood glucose levels ≥250 mg/dl were classified as diabetes mellitus (DM) and continued on the high-fat diet throughout the experiment. Forty-seven male Wistar Albino rats were divided into six groups: a healthy control group, a DM control group, a DM group treated with bexarotene, a DM group treated with icariin, and two DM groups treated with combinations of low and high doses of bexarotene and icariin. After the 45-day treatment, blood samples were collected under thiopental sodium anesthesia, with HbA1c (glycosylated hemoglobin) and hematological parameters analyzed within eight hours, and serum stored at -80°C for further analysis. The animals were then euthanized, and brain tissues were harvested, frozen, and stored at -80°C until further examination. Brain tissues were analyzed for BDNF, GFAP, and NfL levels using ELISA (enzyme-linked immunosorbent assay). For comparing multiple groups, the Kruskal-Wallis test was applied to nonparametric data, and one-way ANOVA was used for parametric data, followed by Bonferroni's post hoc test for pairwise comparisons. Statistical significance was determined with two-tailed tests at p < 0.05. Results Significant changes in GFAP levels were observed across groups (p < 0.001). The DM control group showed the highest GFAP levels, while treatment groups exhibited reductions. The DM control group also showed the highest BDNF levels, while treatment groups exhibited reductions. The DM control group showed the lowest NfL levels, while treatment groups exhibited increments. Conclusion This study highlights the neuroprotective potential of bexarotene and icariin in a diabetic rat model, evidenced by significant changes in GFAP levels. The lack of significant changes in BDNF and NfL suggests that longer study durations may be necessary to observe these effects. Future research should include extended study periods, larger sample sizes, varied dosages, and comprehensive behavioral assessments to better understand the therapeutic potential of these agents.