Analysis Of Variance Research Articles

Matching into Shoulder and Elbow Surgery Fellowships: Do USMLE Scores and AOA Status Still Matter?

IntroductionDespite the established importance of the United States Medical License Exam (USMLE) and Alpha Omega Alpha (AOA) status in orthopedic residency selection, their significance in the fellowship match remains unknown. This study evaluates the influence of USMLE scores and AOA status on interview invitation rates and match positions for shoulder and elbow surgery fellowship applicants. MethodsThis is a retrospective analysis of data from the San Francisco Match database from 2018 to 2023. The study included matched applicants for shoulder and elbow surgery fellowship, excluding unmatched applicants, osteopathic, and international medical graduates. USMLE scores were categorized into four tiers, and interview invitation rates were examined based on USMLE tier and AOA status. Additionally, the association between USMLE scores and AOA status were analyzed by applicant and fellowship rank positions. Statistical analysis included descriptive statistics, linear regression, and analysis of variance. ResultsData from 218 matched applicants were included. On average, applicants submitted 23.3± 9.7 applications, with an average interview rate of 76%. The mean Step 1 and 2 score was 247 ± 11 (n = 141) and 253 ± 12 (n = 171), respectively. USMLE scores showed a positive correlation with interview rates (Step 1: p < 0.0001, B = 0.768; Step 2: p < 0.0001, B = 0.727), indicating that higher scores were associated with increased interview opportunities. AOA members accounted for 38% of applicants (of 183 with available data), and they demonstrated a higher average percentage of interviews compared to non-AOA applicants (79% vs 75%, p < 0.001). While no significant difference in the average Step 1 (p = 0.17) or Step 2 score (p = 0.79) was observed across applicant rank positions, AOA membership was more prevalent among applicants in higher rank tiers (p < 0.001). Additionally, AOA applicants (p < 0.001) and those with higher Step 2 scores (p=0.04) were more likely to be ranked higher by their matched fellowship program. ConclusionUSMLE scores and AOA status correlate with interview invitation rates and applicant ranking for shoulder and elbow surgery fellowships. Future work should examine the influence of residency reputation and research productivity on shoulder and elbow surgery fellowship match outcomes.

Publishing during a Pandemic: Analyzing Recent Publication Times in Hand Surgery

Background: Timely distribution of research is crucial for improving treatments and patient care; however, the publication process is historically unhurried. The primary goal of this study was to analyze the time to publication in hand surgery for 5 years and to examine potential factors affecting publication speed. Methods: A 5-year review (2017–2021) was performed on 4 major hand surgery journals. The Journal of Hand Surgery American Volume, Journal of Hand Surgery European Volume, Journal of Plastic Surgery and Hand Surgery, and Plastic and Reconstructive Surgery were included in the review. Differences were assessed using analysis of variance or 2-sided independent t tests for continuous variables. Results: There was a significant difference in submission-to-publication time between journals (P &lt; 0.001). This differed by year (P &lt; 0.001), with a significant increase in time from submission to publication after 2019, during the COVID-19 pandemic (447 ± 198 versus 406 ± 169 d, P &lt; 0.001). Geographic region of the primary institution did affect submission-to-publication time (P &lt; 0.001). No significant difference was seen in submission-to-publication time based on the number of institutions contributing, article type, or first author or corresponding author surgical specialty (P &gt; 0.05). Conclusions: Time to publication in hand surgery varies by hand surgery journal and significantly increased during the COVID-19 pandemic. New research reflects work done over a year ago at least. Participation in the peer-review process should be encouraged and bolstered within the hand surgery community to improve research dissemination times within the field.

Exploring the effect of diet programs on the behavior of Sudanese children with autism and the prevalence and association of gastrointestinal symptoms: a multi-center cross-sectional study

Background and aims: Autism spectrum disorder (ASD) is a neurodevelopmental condition characterized by social difficulties, speech and nonverbal communication issues, and restricted behaviors. Nutritional issues, such as food allergies and intolerances, can affect children with ASD. This study aimed to evaluate the impact of diet programs on ASD behavior and gastrointestinal symptoms, which would be considered as a starting point to increase the family’s knowledge about how to practice healthy and suitable dieting for their children. Materials and methods: The study was a cross-sectional observational study on 45 children with an autism spectrum disorder in four centers aged 2–18 in Khartoum state. Data was collected through an interview questionnaire, which included sociodemographic, diet, gastrointestinal, and behavioral assessments. The data was analyzed using SPSS to find the correlation between the various variables. Independent t-test, Analysis of Variance, and Mann–Whitney test were used in univariant analysis to assess the association between study variables, while multiple linear regression was used in multivariant analysis for the same purpose Results: The study involved a large number of children with autism spectrum disorder (ASD), with 80% being male and 73.3% being school-aged. Most had parents as guardians and 71.1% were in intermediate financial status. About 20% were overweight or obese, and 57.8% did not have a specific diet program. Food selectivity was prevalent, with 22.7% having allergies to milk and wheat. ASD children experienced vomiting, gastric reflux, abdominal pain, and changes in stool characteristics. A significant link was found between financial status, behavioral status and gastrointestinal changes. High financial status was significantly different from intermediate and low statuses based on behavioral changes. However, no significant association was found in multivariant analysis. Conclusion: The study found that ASD children generally have good nutritional health, with a higher degree of dietary selection. The financial status of guardians significantly influenced behavioral and gastrointestinal changes in the children. Further interventional studies are recommended to assess the direct impact of diet programs on these symptoms.

Thermal optimization of robotic piezoelectric osteotomy motion in porcine trabecular bone

BackgroundPiezoelectric osteotomy represents a potentially viable alternative to conventional techniques for preparing pilot holes for bone screws. However, piezoelectric osteotomes have demonstrated the potential to heat bone beyond 47 °C, which induces necrosis that could contribute to screw loosening, resulting in osteosynthetic material failure and pseudarthrosis. Thus, we sought to determine the working movements of a piezoelectric drill that resulted in the lowest maximum bone temperatures while ensuring that this optimal drilling motion resulted in temperatures below 47 °C. MethodsVertebrae samples were obtained fresh from a local abattoir. A robot was used to drill 15 mm holes through the vertebrae bodies parallel to a sectioned viewing surface, observed with a thermal camera. We tested three significant aspects of the osteotome's movement: the feed rate, retraction speed and working cycle to see which combination resulted in the lowest maximum temperatures. Each factor combination was tested three times for a total of 24 trials. FindingsA feed rate of 2 mm/s, a retraction speed of 2 mm/s and a novel working cycle termed “multi-pass” were found to generate the lowest maximum temperatures (41.5 °C, σ = 1.91 °C). The factors of retraction speed and working cycle demonstrated statistical significance through analysis of variance, with ordinary least squares regression indicating their optimal settings resulted in reductions in maximum temperatures of 4.95 °C and 5.63 °C, respectively. InterpretationRobotic piezoelectric osteotomy appears to represent a safe method of pedicle screw pilot hole preparation from a thermal perspective when using the optimal methods found in this study.

Applicability of few layer graphene derived from annoni grass biomass on the mechanical properties of cement mortars

In this work, we report the potential applicability of few layer graphene (FLG) synthesized from annoni grass (AG) biomass (Eragrostis plana Nees) by investigating its impact on the flexural and compression strength of cement mortars. For this purpose the AG biomass was collected and burnt at the temperature of 400 °C per 60 min, obtaining the AG ash (AGA). For FLG production, the AGA was mixture with the chemical reagent potassium hydroxide (KOH) and burnt at the temperature and time of 850 °C and 60 min, respectively. For the mechanical properties analysis, a reference sample (A0-without FLG) and samples with different percentage of FLG were prepared, specifically 0.02 % (A1), 0.03 % (A2), 0.05 % (A3), 0.07 % (A4) and 0.1 % (A5). Statistical analysis (Analysis of Variance, ANOVA) of the mechanical properties demonstrates a maximum flexural and compression strength in sample A2. The flexural and compression strength increase 25.2 % and 10.1 % compared to the reference mortar. These results indicate that the FLG produced from AG not only improves the mechanical properties of mortars but also presents significant environmental benefits, because AG is considered an invasive pest of agricultural fields of the southern region of Brazil. Therefore, with its removal from the fields it would be contributing to environmental preservation.

Economic and Performance Analysis of Achilles Tendon Rupture in the National Basketball Association

Background: Achilles tendon ruptures are common and potentially career-ending injuries for National Basketball Association (NBA) players. Many studies have reviewed the impact of Achilles tendon ruptures on return to play (RTP) and performance, but there are no studies on their economic significance. Purpose/Hypothesis: This study aimed to analyze the economic and performance consequences of Achilles tendon ruptures usingthe cost of recovery (COR) for NBA franchises as well as preinjury salary/career success. It was hypothesized that players with higher preinjury salaries or performance would have an increased COR, higher rates of RTP, and more career success after their injury. Study Design: Descriptive epidemiology study. Methods: Publicly available data of NBA players who sustained an Achilles tendon rupture between 1990 and 2023 were analyzed. Data were retrospectively gathered by R software code to include players’ ages, positions, salaries, pre- and postinjury player efficiency rating, time missed after injury, and RTP. Performance impact was measured by advanced statistics: player efficiency rating, Win Shares per 48 Minutes, and Value Over Replacement Player. Two groups of 3 cohorts were created: All-Star, Starter, and Reserve versus group A (&lt;$3,999,999), group B (≥$3,999,999 to ≤$8,999,999), and group C (&gt;$8,999,999). Analysis of variance with post hoc Tukey tests for continuous data and Fisher exact tests for categorical data was used. Significance levels were set at P &lt; .05. Results: A total of 37 players met the inclusion criteria and played between the years of 1992 through 2019. The mean COR that NBA teams faced was $4 million per player. The cumulative economic loss from Achilles tendon ruptures in the NBA between 1992 and 2019 was $117,578,851. Overall RTP was 78.38%, and 31.03% of players who returned to play were out of the NBA within 3 years. RTP to the highest playing level was highest in group B (45.5%), followed by group A (40%) then group C (12.5%). The COR of All-Star players, Starter players, and Reserve players averaged $5.7 million, $3.4 million, and $3 million, respectively. Conclusion: This study investigated the financial and performance implications of Achilles tendon ruptures among NBA athletes. Most players struggled to restore their preinjury performance, except for Reserve players. The findings provide valuable insights into the complexities of COR and postinjury performance.

Dynamometry for the Assessment of Trunk Muscle Strength in Postpartum Women with Pregnancy-Related Posterior Pelvic Girdle Pain: A Reliability Study

ObjectivesTo investigate the inter and intra-rater reliability of maximum isometric trunk muscular strength in postpartum women with pregnancy-related posterior pelvic girdle pain using a handheld dynamometer. MethodsThirty women (30.13 ± 3.67 years) with pregnancy-related posterior pelvic girdle pain (PPGP) had their trunk muscular strength assessed using a handheld dynamometer. Inter-rater reliability was estimated for measurements of two separate raters on the first day of the investigation. The tests were repeated with the first rater seven days later to determine the intra-rater reliability. A digital handheld dynamometer was used for testing, and a metal bar was used to secure it to a table. Participants were instructed to use maximal force to push the dynamometer in various trunk flexion, extension, lateral flexion, and rotational orientations. Each trial was repeated three times and averaged to obtain the representative assessment data. Analysis of variance, interclass correlation, absolute agreement, and standard error of measurements were used to evaluate the repeatability of measurements. ResultsExcellent inter and intra-rater reliability were demonstrated. The inter-rater reliability, computed with intraclass correlation coefficient (ICC), ranged from 0.979 to 0.992, and intra-rater reliability (ICC) ranged from 0.966 to 0.987. The standard error of measurement ranged from 0.35% to 1.26% for the different tests. Additionally, the dynamometer values in women with PPGP might be reported using just one trial after an instruction. ConclusionThe maximum isometric trunk muscular strength is reliable, and a quantitative assessment of the trunk strength in women with postpartum pregnancy-related posterior pelvic girdle pain and could be used to monitor the changes in postural stability between sessions.

Optimisation Studies on Performance Enhancement of Spray Cooling - Machine Learning Approach

The performance optimisation of spray cooling heat transfer systems has been identified as a significant step in improving process efficiency, and the application of machine learning tools is a recent development that has enhanced this. This study aims to maximise the heat transfer coefficient for spray cooling at low heat flux levels. The effects of nozzle inclination angle, water pressure, and spray height on heat transfer coefficient were studied. Taguchi L27 orthogonal array technique was used to perform the experiments. A maximum heat transfer coefficient of 181.4 kW/m2K was obtained at a nozzle inclination angle of 60o, spray height of 4 cm, and water pressure of 15 psi. Analysis of variance was performed to find the significance of each variable and its interactions. The results show that for the maximum heat transfer coefficient (181.4 kW/m2K), the optimum levels of the independent variables were A3H1P3, i.e., the highest level of nozzle inclination angle (60o), the lowest level of spray height (4 cm), and the highest level of water pressure (15 psi). The support vector machine outperformed the Random Forest algorithm and Multiple Regression analysis regarding prediction accuracy with a maximum error of 0.15% and root mean squared error of 0.01.

ANTIDEPRESSANT-LIKE ACTIVITY OF AQUEOUS EXTRACT OF ROSA DAMASCENA IN MICE

Objective: Plant-based drugs have the potential to be very effective substitutes for prescription antidepressants. Rosa damascena has therapeutic potential as an analgesic, anticonvulsant, antitussive, bronchodilatory, antibacterial, anti-diabetic, anti-inflammatory, antioxidant, and laxative. Given this context, the goal of the current study was to assess Rosa damascena's potential antidepressant effects. Methods: Maceration was used to create an aqueous extract of Rosa damascena. The Tail Suspension Test (TST) on BALB/c mice and the Forced-Swimming test (FST) on C57BL/6 mice were used to quantify the antidepressant activity. Mice were divided into three groups: control (saline), standard (citalopram and desipramine), and Rosa damascena aqueous extract (n = 6 per group). Intraperitoneally (1 ml/100 g) injections of drugs were administered. Analysis of variance was used to examine the data, and then LSD post-hoc tests were performed. The data are expressed as mean±SEM. Results: Antidepressant-positive controls, citalopram and desipramine, significantly decreased the time of immobility in the FST and TST as compared to the vehicle control group (p&lt;0.001). In FST, the immobility durations were significantly reduced by the Rosa damascena aqueous extract at a dose of 40 mg/kg compared to lesser doses of the same extract (10 and 20 mg/kg) (p&lt;0.001). Similarly, the 40 mg/kg dose of Rosa damascena aqueous extract significantly reduced the length of immobility in TST (p&lt;0.001). Conclusion: The present findings demonstrate Rosa damascena's antidepressant-like effects in mice. Further research is necessary to determine the underlying mechanism by which Rosa damascena generates effects akin to those of an antidepressant in light of this observation.

Association of lamina cribrosa thickness and hippocampal volume in Alzheimer's disease patients.

Alzheimer's disease (AD) is the most common cause of dementia and affects a large portion of the elderly population worldwide. To analyze the relationship between lamina cribrosa thickness (LCT) and hippocampal volume in patients with AD and mild cognitive impairment (MCI). The sample in the present study consisted of 20 recently diagnosed MCI patients, 20 recently diagnosed AD patients, and 20 matched healthy volunteers. Every patient underwent magnetic resonance imaging (MRI) scans. The VolBrain software (open-access platform for MRI brain analysis) was used to calculate the hippocampal volume. Optical coherence tomography was performed to measure the LCT. Analysis of variance and Pearson chi-squared tests were employed to assess the results. The lowest total hippocampal volume (p < 0.05) was in the AD group, which was 6.14 ± 0.66 mm3, while in the control group, it was 7.7 ± 9.65 mm3, and 6.69 ± 0.46 mm3 in the MCI group. In comparison to the rest of the groups, in the AD group, the LCT was the thinnest (202.17 ± 16.35 µm). As per the results of the study population as a whole, low hippocampal volume causes low LCT, which shows an important relationship (r: 0.41; p < 0.05). The current findings present evidence of the relationship between hippocampal volume and LCT in patients with AD and MCI.

Obesity and dental caries in Saudi Arabia: a correlated study

BackgroundObesity and dental caries are two major global public health concerns. There have been conflicting reports about the relationship between obesity and dental caries. This study intends to examine the link between obesity and dental caries across the five regions of Saudi Arabia.MethodsThe study involved 380 participants, which was a cross-sectional survey, with an age range of 6 to 14. We distributed a self-reported questionnaire to assess the participants body mass index (BMI) and caries (dmft/DMFT). In this study, descriptive analysis, student t-test, one-way analysis of variance (ANOVA), and multiple linear regression analysis were used.ResultsThe study comprised 380 respondents, consisting of females (60.8%) and males (39.2%), with a mean age of 9.1 years and mean BMI of 26.3. The prevalence of caries among the study respondents was 66.6% (Table 2), and this prevalence was higher among females (67.5%), those who consumed sugar more than six times (77.5%), those who brushed their teeth once per day (80.3%), those who used no dental floss (68.4%), those who did not use mouthwash or rinse (68.4%), and those in the east and center regions (100%). The obese possess a statistically significant (P < 0.05) higher mean dmft/DMFT (dmft = 8.00 and DMFT = 6.00). Furthermore, BMI had a negative influence on the DMFT score (b = −0.01, P = 0.776), which was not statistically significant.ConclusionParticipants categorized as obese demonstrated a notably higher mean dmft/DMFT in comparison to their non-obese counterparts. Although BMI showed a negative impact on the DMFT score, this association did not reach statistical significance.

Heart rate variability in chronic ischemic stroke: analysis during the sleep-wake cycle.

Alterations of the autonomic nervous system (ANS) in the chronic stage of ischemic stroke (IS) are not well understood. Heart rate variability (HRV) provides a noninvasive approach to assess autonomic function. To compare the HRV parameters during the sleep-wake cycle between patients with IS in the chronic stage and healthy subjects. We conducted a retrospective transversal study based on clinical records and 24-hour electrocardiogram (EKG) monitoring registries of 179 patients with a confirmed IS diagnosis and 184 age- and sex-matched healthy subjects. Circadian variation was calculated according to the variation of the total autonomic activity (VTAI) and the parasympathetic activity (VPAI) indexes. Comparisons were performed using nonparametric tests. Multivariable analyses were performed with canonical discriminant analysis (CDA) and a three-way analysis of variance (ANOVA). Statistical significance was established with a confidence level of 95%. During waking hours, the healthy group exhibited higher variability in the time domain and frequency domain parameters: standard deviation of NN intervals (SDNN, p < 0.001) and of the average NN intervals (SDANN, p < 0.001), as well as low-frequency (LF) band (p < 0.001). During sleep, the difference was higher in the high-frequency (HF) band (p < 0.001), and lower in the low-/high-frequency ratio (LF/HF, p < 0.001). Both VPAI and VTAI showed less significant difference in IS patients (p < 0.001). There was diminished heart vagal activity among IS patients, as measured through HRV. During sleep, this is likely caused by an imbalance in the sympathetic and parasympathetic systems shifting through the sleep phases. These imbalances could persist over time in patients with IS, lasting months after the initial injury.

Glass Ionomer Modified with Bacterial Cellulose Nanocrystals. An In Vitro Analysis Assessing Shear Bond Strength and Microleakage Scores in Deciduous Dentition

The aim of this study was to evaluate the shear bond strength (SBS) and microleakage of bacterial cellulose nanocrystals (BCNCs) incorporated into conventional glass ionomer cement (CGIC) when bonded to deciduous dentin. Sixty primary first and second molars with class I cavitated dentinal lesions were preserved and randomly allocated into two groups based on the technique used for caries removal. Group 1 utilized the conventional approach for caries removal, while Group 2 used Carie Care™ for caries removal. Each of these groups was further divided into two subgroups based on the type of restoration received. Microleakage and failure mode assessments were performed using a stereomicroscope, while SBS testing was conducted using a universal testing machine. The SBS and microleakage scores were analyzed using one-way analysis of variance (ANOVA) and Tukey post hoc test with a significance level of p=0.05. Specimens from Group 1A (conventional approach+CGIC) presented the highest scores of marginal leakage, while Group 1B (conventional approach+BCNCs-modified CGIC) demonstrated the lowest values of microleakage. Additionally, samples from Group 2B (Carie Care™+BCNCs-modified CGIC) revealed the highest bond integrity scores. The incorporation of BCNCs into CGIC had a positive impact on both shear bond strength and marginal leakage when bonded to the dentin substrate. This modification improved the performance of the glass ionomer cement, enhancing its applicability in dental restorations.

Bonding effectiveness of multi-step adhesive resin cements to CAD/CAM blocks: impact of thermal cycling and surface treatment methods

BackgroundTo investigate the effects of thermal cycling and surface treatment methods on the bonding effectiveness of multi-step resin cements to CAD/CAM blocks.MethodsA total of 198 slices, 66 each from CAD/CAM blocks (feldspathic ceramic: Vitablocs TriLuxe Forte, V; resin matrix ceramics (RMCs): Cerasmart, C; and Shofu Block HC, S), were obtained and randomly divided into two subgroups for etching with hydrofluoric acid (HFA) and sandblasting with Al2O3 (SB). After the surface treatments, one etched and one sandblasted sample of each CAD/CAM block was observed via SEM analysis at 500× magnification. The remaining 32 etched and 32 sandblasted samples of each CAD/CAM block were divided into two subgroups to be cemented with total-etch (TE) and self-etch (SE) resin cements. Then, half of the 16 samples in all the subgroups were subjected to aging (TC) for 5000 cycles (n = 8). The shear bond strength (SBS) of each sample was measured. Four-way analysis of variance (ANOVA) and Tukey tests were used to analyze the data (p < 0.05).ResultsWith or without TC, the highest SBS values for V were obtained with the HFA-TE and HFA-SE interactions, respectively. C presented the highest SBS values with HFA-SE and SB-TE interactions, whereas S presented the highest SBS values with SB-TE and HFA-TE interactions. Except the SB-SE interaction, C presented lower SBS values after TC than other materials. HFA created less porosity on the C and S surfaces than V. SB visibly roughened the surfaces of all the materials but caused fractures, cracks, and damage to the surfaces.ConclusionSimilar SBS values can be achieved between feldspathics, RMCs, and multi-step adhesive resins with both HFA and SB treatments. However, the SBS values obtained from the SB-SE interaction may be below the recommended threshold values for all materials after TC. SB can cause distinctive cavities, fissures, and damage, especially on the surfaces of RMCs.

Longitudinal Evolution of the Brain Microstructure in Cirrhotic Patients on Diffusion Kurtosis Imaging.

Although improvement of cognitive function after liver transplantation has been demonstrated in several neuropsychological studies, there is limited research on longitudinal changes in the cirrhotic patients' brain structure before and after transplantation. To investigate longitudinal changes of brain microstructure in cirrhotic patients using diffusion kurtosis imaging (DKI). Prospective. A total of 153 cirrhosis patients, comprising 60 hepatic encephalopathy (HE) patients (16 females/44 males) and 93 no-HE patients (35 females/58 males), along with 93 healthy controls (HCs) (53 females/40 males) were enrolled. Subsequently, 58 recipients completed 1-month postoperative follow-up, 29 patients completed 1-, 3-months, and 17 patients completed 1-, 3-, 6-month follow-up. Spin-echo single-shot echo-planar sequence using a 3.0 T scanner. Diffusion kurtosis estimator software was used to estimate the DKI parameter maps by a MR imaging physicist (Y.-Y.C. with 12 years of experience). The diffusion metrics (eg, radial kurtosis [RK], mean kurtosis, fractional anisotropy, mean diffusivity) of the patients before transplantation were compared with those of the HCs using voxel-wise analysis of variance (ANOVA), along with t tests for post hoc analysis. Linear mixed-effects models were applied to the longitudinal data. We imposed a cluster level Family Wise Error (FWE) correction rate of PFWE = 0.05 with voxel-wise cutoff of P = 0.001 together with a cluster-size cutoff of N ≥ 56, and generated smoothness estimates from the preprocessed data using the mixed-model autocorrelation function. The RK metrics of the patients decreased significantly in the anterior cingulate cortex (HE/no-HE < HC, ANOVA-F = 21.91). After transplantation, the RK of the pallidum showed a continuous upward trend (time effect T = 11.26); whereas the RK of the right postcentral gyrus showed a continuous downward trend (time effect T = -9.56). In addition, the RK in superior longitudinal fasciculus showed new-onset decrease after transplantation. Longitudinal changes in DKI metrics reveal the course of brain microstructural changes before and after transplantation in cirrhotic patients, potentially associated with cognitive alterations after surgery. 1 TECHNICAL EFFICACY: Stage 4.

Effect of pores and moisture on the mechanical properties of calcium silicate hydrate gels at mesoscale

Pores and moisture significantly influence the mechanical properties of cementitious materials. Investigating the effects of pores and moisture on the mechanical properties of calcium silicate hydrate (C-S-H) gels at the mesoscale is fundamental to understanding the multiscale behavior of these materials. In this study, mesoscopic models of C-S-H gels with varying porosities were developed using coarse-grained C-S-H nanoparticles. The potential function, describing the interaction between C-S-H nanoparticles under different humidity conditions, was derived based on the mechanical properties of C-S-H nanoparticles, the Lennard-Jones (LJ) potential, and capillary theory. Subsequently, simulations of uniaxial tensile, uniaxial compression, and shear experiments on C-S-H gels with different porosities and moisture levels were conducted. The influence of pores and moisture on the mechanical properties of C-S-H gels was analyzed using two-way analysis of variance (ANOVA) and then compared with mesoscopic influence patterns. The results showed that the mechanical properties of C-S-H gels decrease with increasing porosity and moisture at the mesoscale. And there is an interaction effect between gel pore porosity and moisture. The smaller the porosity, the more significant the weakening effect of increasing moisture on elastic parameters and strength. Conversely, the weakening effect of increasing porosity on elastic parameters and strength is more significant at lower moisture levels. The interaction between pores and moisture has a more pronounced effect on strength, which intensifies with increased moisture. The effect of porosity on the mechanical properties of C-S-H gels is consistent with macroscale studies. However, the effect of moisture on elastic parameters exhibits an opposite trend, attributed to the different mechanisms of water's influence at different scales.

Role of anxiolytic medications in maintaining perioperative blood pressure in total hip arthroplasty surgeries: case-control retrospective study

Background: Elevated blood pressure (BP) measurements seen in patients having total hip arthroplasty (THA), pose a significant issue for surgeons. The study objective was to investigate the effectiveness of preoperative anxiolytic medications in the maintenance of blood pressure and reduction of total blood loss in patients undergoing THA surgeries. Methods: A retrospective case-control cohort study in a tertiary care university hospital included patients who had THA and had either primary managed hypertension or were non-hypertensive. 190 patients who underwent primary THR; 103 controls and 87 treatment group (Oral 3 mg Bromazepam). Pearson’s chi-square, independent sample t-test, paired samples t-test, and a two- way repeated measures analysis of variance (ANOVA) was utilized in the analysis. Results: Bromazepam group had a significantly lowered ratio of systolic (SBP), diastolic (DBP), and mean arterial pressure (MAP) in the morning of the surgery (P&lt;0.05). Bromazepam also reduced the ratio of SBP and MAP in theaters before anesthesia (P&lt;0.05). A repeated measures ANOVA showed significant treatment effects for SBP and MAP but not DBP (P&lt;0.001 for both). SBP, DBP, and MAP showed a significant time-treatment effect (P&lt;0.001, 0.019, and&lt;0.001, respectively). Conclusions: Oral bromazepam (anxiolytic) aids in the regulation of blood pressure in individuals with well-managed hypertension and in healthy patients having total hip arthroplasty without apparent adverse effects related to the medication. This could potentially reduce the number of uncontrolled hypertension-related surgery delays and patients on the surgical waiting list.

Exposure to the herbicide 2,4-dichlorophenoxyacetic acid and prostate cancer among U.S. adult men.

Prostate cancer is the second most diagnosed male malignancy in the U.S. 2,4-Dichlorophenoxyacetic acid (2,4-D) is a commonly used herbicide and potential carcinogen. The researchers evaluated the association between prostate cancer and 2,4-D. Data was leveraged from the National Health and Nutrition Examination Survey (NHANES), a population-based, cross-sectional study of men and women in the U.S. Our cohort of interest was men aged 50 years and over. Urinary 2,4-D served as the measure of exposure. Our primary outcome was history of prostate cancer based on an individual's reply of "yes" to either ever having been diagnosed with prostate cancer and/or having received treatment for prostate cancer. Chi-square, one-way analysis of variance (ANOVA), and multivariable, weighted logistic regression were used to analyze the relationship between 2,4-D and prostate cancer. We identified 1,788 eligible men, representing an estimated 691,709 men after survey weighting. The median 2,4-D level was 0.28µg/L (IQR: 0.26-0.53), and the geometric mean was 0.38µg/L. Increasing exposure of 2,4-D was associated with prostate cancer (OR 1.72, 95% CI [1.2,2.4]). Individuals in the highest quartile of 2,4-D exposure had a higher odds of a prostate cancer diagnosis compared to the lowest quartile (OR = 3.46 95% CI [1.11,10.72]). Age stratification revealed statistically significant associations between 2,4-D and prostate cancer in men age 70 + who were in the highest quartile of exposure (OR = 3.79 95% CI [1.51,9.52]). These findings implicate 2,4-D exposure in the risk of prostate cancer. Future studies are warranted to corroborate these findings and elucidate potential mechanisms underlying these associations.

Investigation of fracture resistance with different diameters of polyetherketoneketone posts and cores material: A pilot study

Objectives: The primary objective of this study is to investigate the resistance to fracture of Polyetherketoneketones PEKK, used as post and core by fabrication in different diameters in the canal, and comparing the test results for each group. Methods: Thirty extracted mandibular premolars were selected, endodontically treated and prepared to receive the post and cores milled from polyetherketoneketone disk. The specimens were randomly divided into five groups (n = 6) respectively: group 1 received pekk post with diameter = 0.70 mm, group 2 received pekk post with diameter = 0.90 mm, group 3 received pekk post with diameter = 1.10 mm, group 4 received pekk post with diameter = 1.50 mm, and group 5 received pekk post with diameter = 1.70 mm. All the posts were cemented using a self-adhesive resin cement. Fracture resistance was tested using a universal testing machine, failure patterns were then observed visually and radiographically. For the fracture resistance test, the Universal Testing machine employed the load cell of 10KN and the speed of the cross head of 1mm/min. Data was analyzed using Oneway analysis of variance (ANOVA) followed by Tukey post-hoc test in order to determine significant differences among groups and the materiality threshold was set at α = 0.05. Results: Statistical analysis revealed that the observed differences among the five groups were not significant. None of the PEKK posts caused any fracture in the root, and this observation was visually and radiographically confirmed across all groups. Conclusions: The dentist will be able to turn the diameter of the PEKK post and core as thin as 0.70mm till 1.70mm depending on the clinical requirement with no risk of root fracture, as specified by the guidelines of this research.

Understanding COVID‐19 Vaccine Acceptance Among Iranian Pregnant Women: Insights From a Multicenter Cross‐Sectional Study

ABSTRACTBackground and AimsDespite significant advancements in COVID‐19 vaccine research and development, hesitancy in its acceptance, particularly among pregnant women, is recognized as a health threat. Based on the Health Belief Model, this study aimed to identify the factors influencing vaccine nonacceptance among pregnant women in the cities of Zahedan and Tabriz, Iran.MethodsThe present research was a multicenter cross‐sectional study conducted among pregnant women in two Iranian provinces, Zahedan and Tabriz, covering both high and low fertility regions. The study was conducted from February 2022 to August 2022. The sample size comprised 650 pregnant women attending selected healthcare centers. Data collection tools included questionnaires on sociodemographic characteristics, awareness, vaccine acceptance, and health beliefs related to vaccination. Data were analyzed using descriptive and analytical methods, including Analysis of variance (ANOVA), Independent t‐test, and multivariable logistic regression.ResultsAmong the 650 pregnant women, the vaccine acceptance rate was 47.4% and 52.6% of pregnant women reported vaccine nonacceptance during pregnancy. The logistic regression model indicated that the odds of vaccine acceptance increase with maternal employment (OR = 11.53, 95% CI: 4.81–27.63), higher maternal education levels (OR = 6.97, 95% CI: 3.11–15.63), higher income (OR = 1.60, 95% CI: 1.07–2.55), and increased awareness levels (OR = 1.37, 95% CI: 1.03–1.52). Additionally, the odds of vaccine acceptance increase with increased perceived susceptibility (OR = 2.55, 95% CI: 0.47–3.76), increased perceived benefits (OR = 2.22, 95% CI: 1.06–4.61), increased perceived barriers (OR = 0.42, 95% CI: 0.18–1.12), and increased cues to action (OR = 2.01, 95% CI: 1.03–3.92).ConclusionOur study underscores the multifaceted nature of COVID‐19 vaccine acceptance among pregnant women, with socioeconomic, awareness‐related, and psychological factors all playing pivotal roles. These findings can inform targeted interventions and strategies aimed at increasing vaccine acceptance in this vulnerable population, ultimately contributing to enhanced maternal and fetal health during the ongoing pandemic.