Efficacy of microchips and 3D sensors for orthodontic force measurement: A systematic review of in vitro studies.

OBJECTIVE: To evaluate the efficacy of microchips and 3D microsensors in the measurement of orthodontic forces. METHODS: Through September 2023, comprehensive searches were conducted on PubMed/MEDLINE, SCOPUS and SCIELO without restrictions. RESULTS: After removing duplicate entries and applying the eligibility criteria, 23 studies were included for analysis. All the studies were conducted in vitro, and slightly more than half of them were centred on evaluating orthodontic forces exerted by aligners. Eight utilized microchips as measurement tools, while the remaining studies made use of 3D microsensors for their assessments. In the context of fixed appliances, key findings included a high level of agreement in 3-dimensional orthodontic force detection between simulation results and actual applied forces. Incorporating critical force-moment combinations during smart bracket calibration reduced measurement errors for most components. Translational tooth movement revealed a moment-to-force ratio, aligning with the bracket's centre of resistance. The primary findings in relation to aligners revealed several significant factors affecting the forces exerted by them. Notably, the foil thickness and staging were found to have a considerable impact on these forces, with optimal force transmission occurring at a layer height of 150 µm. Furthermore, the type of material used in 3D-printing aligners influenced the force levels, with attachments proving effective in generating extrusive forces. Deliberate adjustments in aligner thickness were observed to alter the forces and moments generated. CONCLUSIONS: Microchips and 3D sensors provide precise and quantitative measurements of orthodontic forces in in vitro studies, enabling accurate monitoring and control of tooth movement.

A common regulatory switch controls a suite of C4 traits in multiple cell types.

The C4 photosynthetic pathway provided a major advantage to plants growing in hot, dry environments, including the ancestors of our most productive crops. Two traits were essential for the evolution of this pathway: increased vein density and the functionalization of bundle sheath cells for photosynthesis. Although GRAS transcriptional regulators, including SHORT ROOT (SHR), have been implicated in mediating leaf patterning in both C3 and C4 species, little is known about what controls the specialized features of the cells that mediate C4 metabolism and physiology. We show in the model monocot, Setaria viridis, that SHR regulates components of multiple cell identities, including chloroplast biogenesis and photosynthetic gene expression in bundle sheath cells, a central feature of C4 plants. Furthermore, we found that it also contributes to the two-cell compartmentalization of the characteristic four-carbon shuttle pathway. Disruption of SHR function clearly reduced photosynthetic capacity and seed yield in mutant plants under heat stress. Together, these results show how cell identities are remodeled by SHR to host the suite of traits characteristic of C4 regulation, which are a main engineering target in non-C4 crops to improve climate resilience.

Smile Aesthetics Assessment in Patients Undergoing the Finishing Phase of Orthodontic Treatment: An Observational Cross-Sectional Study.

Objective To describe the smile characteristics of patients entering the finishing phase of orthodontic treatment. Methods This observational study involved a non-probabilistic sample of 48 patients. Clinical records served as the basis for determining the type of treatment (with or without extractions). Photographs were analyzed to obtain smile variables. Dental casts and panoramic radiographs were evaluated to ascertain the cast-radiograph evaluation (CRE) index. Univariate and bivariate analyses were conducted at a significance level of 0.05. Results The study evaluated 24 men and 24 women, with an average age of 20.10 ± 6.78 years. Fifty percent of the patients did not undergo extractions, and the average CRE index for the sample was 34.83 ± 9.01. Regarding the smile, a medium smile line was prevalent in 66.7% of cases, and a non-consonant smile arc was observed in 58.3%. Significant differences in the smile arc were found between patients with and without extractions (p=0.019). Right and left buccal corridors measured 2.52 mm ± 1.52 and 2.43 mm ± 1.37, respectively. The upper dental midline deviated by 0.80 ± 0.91 mm and had an angulation of 1.65 ± 2.05º. Both variables showed significant differences between Class I and Class II patients (p=0.020; p=0.027). Symmetrical smiles were also observed (1.05 ± 0.17). Conclusions Based on our findings, clinicians should focus on the smile arc in patients who have not undergone extractions and on the midline inclination in Class II patients. These appear to be the most common areas for improvement in patients who are in the finishing phase of treatment. Additionally, considerable variability exists in the smile characteristics of patients still undergoing orthodontic treatment, leaving room for further enhancement of results.

Surface immunogenic protein from Streptococcus agalactiae and Fissurella latimarginata hemocyanin are TLR4 ligands and activate MyD88- and TRIF dependent signaling pathways.

The development of vaccine adjuvants is of interest for the management of chronic diseases, cancer, and future pandemics. Therefore, the role of Toll-like receptors (TLRs) in the effects of vaccine adjuvants has been investigated. TLR4 ligand-based adjuvants are the most frequently used adjuvants for human vaccines. Among TLR family members, TLR4 has unique dual signaling capabilities due to the recruitment of two adapter proteins, myeloid differentiation marker 88 (MyD88) and interferon-ß adapter inducer containing the toll-interleukin-1 receptor (TIR) domain (TRIF). MyD88-mediated signaling triggers a proinflammatory innate immune response, while TRIF-mediated signaling leads to an adaptive immune response. Most studies have used lipopolysaccharide-based ligands as TLR4 ligand-based adjuvants; however, although protein-based ligands have been proven advantageous as adjuvants, their mechanisms of action, including their ability to undergo structural modifications to achieve optimal immunogenicity, have been explored less thoroughly. In this work, we characterized the effects of two protein-based adjuvants (PBAs) on TLR4 signaling via the recruitment of MyD88 and TRIF. As models of TLR4-PBAs, we used hemocyanin from Fissurella latimarginata (FLH) and a recombinant surface immunogenic protein (rSIP) from Streptococcus agalactiae. We determined that rSIP and FLH are partial TLR4 agonists, and depending on the protein agonist used, TLR4 has a unique bias toward the TRIF or MyD88 pathway. Furthermore, when characterizing gene products with MyD88 and TRIF pathway-dependent expression, differences in TLR4-associated signaling were observed. rSIP and FLH require MyD88 and TRIF to activate nuclear factor kappa beta (NF-κB) and interferon regulatory factor (IRF). However, rSIP and FLH have a specific pattern of interleukin 6 (IL-6) and interferon gamma-induced protein 10 (IP-10) secretion associated with MyD88 and TRIF recruitment. Functionally, rSIP and FLH promote antigen cross-presentation in a manner dependent on TLR4, MyD88 and TRIF signaling. However, FLH activates a specific TRIF-dependent signaling pathway associated with cytokine expression and a pathway dependent on MyD88 and TRIF recruitment for antigen cross-presentation. Finally, this work supports the use of these TLR4-PBAs as clinically useful vaccine adjuvants that selectively activate TRIF- and MyD88-dependent signaling to drive safe innate immune responses and vigorous Th1 adaptive immune responses.

Humoral immunity against SARS-CoV-2 evoked by heterologous vaccination groups using the CoronaVac (Sinovac) and BNT162b2 (Pfizer/BioNTech) vaccines in Chile.

Introduction: Severe acute respiratory syndrome virus 2 (SARS-CoV-2) has caused over million deaths worldwide, with more than 61,000 deaths in Chile. The Chilean government has implemented a vaccination program against SARS-CoV-2, with over 17.7 million people receiving a complete vaccination scheme. The final target is 18 million individuals. The most common vaccines used in Chile are CoronaVac (Sinovac) and BNT162b2 (Pfizer-Biotech). Given the global need for vaccine boosters to combat the impact of emerging virus variants, studying the immune response to SARS-CoV-2 is crucial. In this study, we characterize the humoral immune response in inoculated volunteers from Chile who received vaccination schemes consisting of two doses of CoronaVac [CoronaVac (2x)], two doses of CoronaVac plus one dose of BNT162b2 [CoronaVac (2x) + BNT162b2 (1x)], and three doses of BNT162b2 [BNT162b2 (3x)]. Methods: We recruited 469 participants from Clínica Dávila in Santiago and the Health Center Víctor Manuel Fernández in the city of Concepción, Chile. Additionally, we included participants who had recovered from COVID-19 but were not vaccinated (RCN). We analyzed antibodies, including anti-N, anti-S1-RBD, and neutralizing antibodies against SARS-CoV-2. Results: We found that antibodies against the SARS-CoV-2 nucleoprotein were significantly higher in the CoronaVac (2x) and RCN groups compared to the CoronaVac (2x) + BNT162b2 (1x) or BNT162b2 (3x) groups. However, the CoronaVac (2x) + BNT162b2 (1x) and BNT162b2 (3x) groups exhibited a higher concentration of S1-RBD antibodies than the CoronaVac (2x) group and RCN group. There were no significant differences in S1-RBD antibody titers between the CoronaVac (2x) + BNT162b2 (1x) and BNT162b2 (3x) groups. Finally, the group immunized with BNT162b2 (3x) had higher levels of neutralizing antibodies compared to the RCN group, as well as the CoronaVac (2x) and CoronaVac (2x) + BNT162b2 (1x) groups. Discussion: These findings suggest that vaccination induces the secretion of antibodies against SARS-CoV-2, and a booster dose of BNT162b2 is necessary to generate a protective immune response. In the current state of the pandemic, these data support the Ministry of Health of the Government of Chile's decision to promote heterologous vaccination as they indicate that a significant portion of the Chilean population has neutralizing antibodies against SARS-CoV-2.

Infectious Diseases Consultation Associated With Reduced Mortality in Gram-Negative Bacteremia.

Gram-negative bacteremia (GN-BSI) can cause significant morbidity and mortality, but the benefit of infectious diseases consultation (IDC) is not well defined. A 24-site observational cohort study of unique hospitalized patients with 4861 GN-BSI episodes demonstrated a 40% decreased risk of 30-day mortality in patients with IDC compared to those without IDC.

Antibiotic resistance in periodontitis patients: A systematic scoping review of randomized clinical trials.

OBJECTIVES: The objective of the study was to evaluate the prevalence and proportions of antibiotic-resistant species in periodontitis patients. METHODS: A systematic scoping review of randomized clinical trials (RCTs) was conducted using the PRISMA extension for scoping reviews involving different databases. MeSH terms and keywords were provided to examine only RCTs with antibiotic-resistant results that included at least 3 months of follow-up of systematically healthy patients diagnosed with periodontitis and treated with systemic or local antibiotics adjunctive to subgingival debridement. RCTs that managed participants surgically, duplicate publications, and investigations implemented on animals were discarded. RESULTS: Six RCTs were chosen. These studies included 465 patients. Most investigations observed that while Aggregatibacter actinomycetemcomitans, Tannerella forsythia, and Porphyromonas gingivalis had low resistance to amoxicillin, microorganisms in many sites showed resistance to tetracycline, metronidazole, and azithromycin pretreatment. A. actinomycetemcomitans showed high resistance to tetracycline pre- and post-therapy. The proportion of antibiotic-resistant samples augmented rapidly after the prescription of antibiotics in all test groups. The percentage of antibiotic-resistant microorganisms decreased over time; at the end of the follow-up period, resistance levels were close to baseline levels. CONCLUSIONS: Adjunctive local and systemic antibiotic treatment temporarily increased the antibiotic resistance of subgingival microorganisms; nonetheless, many bacteria remained susceptible to antibiotics during their administration.

Pseudorandom number generator based on novel 2D Hénon-Sine hyperchaotic map with microcontroller implementation.

Recently, chaotic maps have been considered to design pseudorandom number generator (PRNG). However, some chaotic maps present security disadvantages, such as low uniformity and low randomness properties. Nowadays, chaos-based PRNGs are used as the main source for the development of cryptographic algorithms. In this work, to overcome such weaknesses, a novel 2D hyperchaotic map is proposed based on discrete-time feedback by using Hénon map and Sine map. In addition, the dynamics of the hyperchaotic map are enhanced by using the remainder after division function (rem), where better random statistical properties are obtained. A comparison is made between the enhanced Hénon-Sine hyperchaotic map (EHSHM) and the Hénon-Sine hyperchaotic map through Lyapunov exponent analysis, attractor trajectory, histograms and sensitivity at initialization. Then, 8-bit pseudorandom number generator based on the proposed hyperchaotic map (PRNG-EHSHM) is designed and the initial seed of the PRNG is calculated by a secret key of 60 hexadecimal characters. It is implemented in both MATLAB and Arduino Mega microcontroller for experimental results. A complete security analysis is presented from a cryptographic point of view, such as key space, floating frequency, histograms and entropy of the information. Moreover, the randomness is verified with the tests of the National Institute of Standards and Technology (NIST 800-22). Based on the security results obtained, the proposed PRNG-EHSHM can be implemented in embedded cryptographic applications based on chaos.

Oral lesions in patients with human monkeypox: A systematic scoping review.

OBJECTIVES: To describe the clinical features and location of oral lesions in patients with human monkeypox. METHODS: A systematic scoping review was accomplished by implementing the Preferred Reporting Items for Systematic Reviews and Meta-analyses extension for scoping reviews. The analysis incorporated varied databases and the gray literature. Keywords were implemented to search publications in all languages until July 2022. RESULTS: The initial electronic exploration included 889 reports, of which 843 studies were eliminated. Reading the full text occasioned the omission of 27 additional investigations. Finally, 19 publications were included. These reports analyzed 1256 patients with monkeypox, mostly described in Europe. Most of them were men who have sex with men. The study population consisted mainly of adults but children were also infected. The oral lesions of monkeypox patients were observed in different parts of the oral mucosa, including lips and tongue, but mainly in the tonsils (15 cases). The oral lesions manifested as papules, vesicles, pustules, and ulcers. Erythema, edema, enanthema, and severe pain were also observed, accompanied by tonsillar enlargement. Sore throat was also reported. Monkeypox is accompanied by a significant number of systemic manifestations, mainly including multiple skin lesions throughout the body, as well as lymphadenopathy, fever, headache, myalgia, and fatigue, among others. The symptoms associated with monkeypox were managed with different antiretroviral and antimicrobial therapies and medications to control pain and fever principally. Seventeen deaths were informed. CONCLUSION: Most monkeypox-associated oral lesions are seen in different parts of the oral mucosa, mainly in the tonsils manifested as papules, vesicles, pustules, and ulcers.

Efficacy of CAD/CAM Technology in Interventions Implemented in Orthodontics: A Scoping Review of Clinical Trials.

Objectives: To evaluate the efficacy of computer-aided design/computer-aided manufacturing (CAD/CAM) technology in interventions implemented in orthodontics. Methods: A scoping review of scientific evidence was accomplished, involving different databases. MesH terms and keywords were provided to examine clinical trials (CTs) in all languages. Exclusively CTs that fulfilled the eligibility criteria were admitted. Results: Eight CTs were chosen. These experiments evaluated 542 patients. Four CTs compared the computer-aided indirect bonding method versus the traditional direct bonding of orthodontic brackets. Three CTs compared CAD/CAM retainers with other types of retainers, and one CT compared the CAD/CAM group with multistranded stainless steel wires versus stainless steel wires. Regarding the efficacy of the interventions with CAD/CAM technology used in orthodontics, variable results were found. The indirect bonded customized CAD/CAM brackets presented just a slight effect on the treatment efficacy and therapy results. Two CTs showed that an indirect bonding self-ligating standard system had a similar quality of therapy in comparison with the CAD/CAM customized bracket system. Concerning the clinical failure rate, no differences were presented between the CAD/CAM retainer and other retainers. A CAD/CAM system had more loose brackets than a noncustomized system and was observed also a greater amount of immediate debonding with CAD/CAM indirect bonding than with direct bonding. CAD/CAM fixed retainers revealed inferior relapse and fewer failures than lab-based and conventional chairside retainers. No changes between treatment groups were observed regarding the total therapy time, amount of appointments, and quantity of archwire bends. Conclusions: In general terms, no greater efficacy of CAD/CAM technology was observed over traditional therapies used in orthodontics. However, it was found that gingival inflammation and the accumulation of bacterial plaque and dental calculus were lower when CAD/CAM retainers were used. When comparing interventions that include CAD/CAM systems with conventional therapies, no significant reduction in care times was found.

Secondary Cases of Delta Variant Coronavirus Disease 2019 Among Vaccinated Healthcare Workers With Breakthrough Infections is Rare.

In a retrospective, cohort study at 4 medical centers with high coronavirus disease 2019 vaccination rates, we evaluated breakthrough severe acute respiratory syndrome coronavirus 2 Delta variant infections in vaccinated healthcare workers. Few work-related secondary cases were identified. Breakthrough cases were largely due to unmasked social activities outside of work.

Validation of a Methodology for the Detection of Severe Acute Respiratory Syndrome Coronavirus 2 in Saliva by Real-Time Reverse Transcriptase-PCR.

In January 2021, the Chilean city of Concepción experienced a second wave of coronavirus 2019 (COVID-19) while in early April 2021, the entire country faced the same situation. This outbreak generated the need to modify and validate a method for detecting severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) in saliva, thereby expanding the capacity and versatility of testing for COVID-19. This study was conducted in February 2021 in the Chilean city of Concepción during which time, the town was under total quarantine. The study participants were mostly symptomatic (87.4%), not hospitalized, and attended care centers because of their health status rather than being asked by the researchers. People coming to the health center in Concepción to be tested for COVID-19 (via reverse transcriptase polymerase chain reaction [RT-PCR]) from a specimen of nasopharyngeal swab (NPS) were then invited to participate in this study. A total of 131 participants agreed to sign an informed consent and to provide saliva and NPS specimens to validate a method in terms of sensitivity, specificity, and statistical analysis of the cycle threshold (Ct) values from the RT-PCR. Calculations pertaining to the 127 participants who were ultimately included in the analysis showed sensitivity and specificity at 94.34% (95% CI: 84.34-98.82%) and 98.65% (95% CI: 92.70-99.97%), respectively. The saliva specimen showed a performance comparable to NPS as demonstrated by the diagnostic parameters. This RT-PCR method from the saliva specimen is a highly sensitive and specific alternative compared to the reference methodology, which uses the NPS specimen. This modified and validated method is intended for use in the in vitro diagnosis of SARS-CoV-2, which provides health authorities in Chile and local laboratories with a real testing alternative to RT-PCR from NPS.

The Microcirculatory Response to Endotoxemia and Resuscitation Is a Marker of Regional Renal Perfusion, Renal Metabolic Stress, and Tubular Injury.

Aims: We sought to investigate the relationship between macrohemodynamic resuscitation and microcirculatory parameters with the response of microcirculatory flow, tissue-specific parameters of metabolic stress and injury. We hypothesized that early resuscitation based on macrohemodynamic parameters does not prevent the development of organ dysfunction in a porcine model of endotoxemic shock, and that sublingual microcirculatory parameters are associated with markers of tissue metabolic stress and injury. Results: Both resuscitation groups had significant increases in creatinine and neutrophil gelatinase-associated lipocalin as compared with baseline. Neither the macrovascular response to endotoxemia or resuscitation, nor group allocation predicted the development of acute kidney injury (AKI). Only a microvascular flow index (MFI) <2.5 was associated with the development of renal tubular injury and AKI, and with increased renal, liver, peritoneal, and sublingual lactate/pyruvate (L/P) ratio and lactate. Among systemic parameters, only partial pressure of carbon dioxide (PCO2) gap >6 and P(a-v)CO2/C(v-a)O2 >1.8 were associated with increased organ L/P ratio and AKI. Innovation and Conclusion: Our findings demonstrate that targeting macrohemodynamics to guide resuscitation during endotoxemic shock failed to predict tissue metabolic stress and the response of the microvasculature to resuscitation, and was unsuccessful in preventing tubular injury and AKI. Mechanistically, our data suggest that loss of hemodynamic coherence and decoupling of microvascular flow from tissue metabolic demand during endotoxemia may explain the lack of association between macrohemodynamics and perfusion goals. Finally, we demonstrate that MFI, PCO2 gap, and P(v-a)CO2/C(a-v)O2 ratio outperformed macrohemodynamic parameters at predicting the development of renal metabolic stress and tubular injury, and therefore, that these indices merit further validation as promising resuscitation targets. Antioxid. Redox Signal. 35, 1407-1425.

Mitigation of a Coronavirus Disease 2019 Outbreak in a Nursing Home Through Serial Testing of Residents and Staff.

Nursing homes and long-term care facilities represent highly vulnerable environments for respiratory disease outbreaks, such as coronavirus disease 2019 (COVID-19). We describe a COVID-19 outbreak in a nursing home that was rapidly contained by using a universal testing strategy of all residents and nursing home staff.

Molecular and epidemiological characterization of imported malaria cases in Chile.

BACKGROUND: Chile is one of the South American countries certified as malaria-free since 1945. However, the recent increase of imported malaria cases and the presence of the vector Anopheles pseudopunctipennis in previously endemic areas in Chile require an active malaria surveillance programme. METHODS: Specimens from 268 suspected malaria cases-all imported-collected between 2015 and 2018 at the Public Health Institute of Chile (ISP), were diagnosed by microscopy and positive cases were included for epidemiological analysis. A photo-induced electron transfer fluorogenic primer real-time PCR (PET-PCR) was used to confirm the presence of malaria parasites in available blood samples. Sanger sequencing of drug resistance molecular markers (pfk13, pfcrt and pfmdr1) and microsatellite (MS) analysis were performed in confirmed Plasmodium falciparum samples and results were related to origin of infection. RESULTS: Out of the 268 suspected cases, 65 were Plasmodium spp. positive by microscopy. A total of 63% of the malaria patients were male and 37% were female; 43/65 of the patients acquired infections in South American endemic countries. Species confirmation of available blood samples by PET-PCR revealed that 15 samples were positive for P. falciparum, 27 for Plasmodium vivax and 4 were mixed infections. The P. falciparum samples sequenced contained four mutant pfcrt genotypes (CVMNT, CVMET, CVIET and SVMNT) and three mutant pfmdr1 genotypes (Y184F/S1034C/N1042D/D1246Y, Y184F/N1042D/D1246Y and Y184F). MS analysis confirmed that all P. falciparum samples presented different haplotypes according to the suspected country of origin. Four patients with P. vivax infection returned to the health facilities due to relapses. CONCLUSION: The timely detection of polymorphisms associated with drug resistance will contribute to understanding if current drug policies in the country are appropriate for treatment of imported malaria cases and provide information about the most frequent resistant genotypes entering Chile.

Development and analytical validation of real-time PCR for the detection of Streptococcus agalactiae in pregnant women.

BACKGROUND: Group B Streptococcus (GBS) is the leading cause of invasive neonatal infection. In this study, we aimed to evaluate the analytical validation of qualitative real-time polymerase chain reaction (qPCR) as a means to detect GBS. METHODS: Genomic DNA (gDNA) was purified from 12 ATCC bacterial strains, two belonging to GBS and the remainder acting as negative controls. Additionally, gDNA was isolated from 21 strains of GBS from various serotypes (Ia, Ib and II-VIII). All gDNA was used to evaluate the analytical validation of the qPCR method employing a specific Taqman probe. Inclusivity, exclusivity, anticipated reportable range, the limit of detection and robustness were evaluated. The methods used are described in international guidelines and other existing reports. The performance of this qPCR method for detecting GBS was compared to other microbiological methods used with vaginal-rectal samples from pregnant women. RESULTS: Our qPCR method for detecting GBS was analytically validated. It has a limit of detection of 0.7 GE/µL and 100% analytical specificity. It detects all strains of GBS with the same level of performance as microbiological methods. CONCLUSION: Data suggest that this qPCR method performs adequately as a means to detect GBS in vaginal-rectal swabs from pregnant women.

Assessment of the American College of Surgeons National Surgical Quality Improvement Program Calculator in Predicting Outcomes and Length of Stay After Ivor Lewis Esophagectomy: A Single-Center Experience.

BACKGROUND: The American College of Surgeons (ACS) National Surgical Quality Improvement Program (NSQIP) calculator is a useful tool used by physicians to better inform patients on the surgical risk of postoperative complications. It makes use of the NSQIP database to derive the chance for several adverse outcomes to occur postoperatively given certain patient's factors. The aim of this study was to assess its applicability in a series of patients undergoing an Ivor Lewis esophagectomy. METHODS: Data from 100 consecutive patients who underwent an Ivor Lewis esophagectomy between September 2013 and November 2017 at our institution were reviewed. Each patient was assessed using the ACS NSQIP surgical risk calculator. Actual events in this group were compared with their particular NSQIP-assessed risk. Logistic regression models were used to compare surgical risk calculator estimates binary outcomes such as incidence of postoperative complications such as cardiac events, renal events, surgical site infection, and death. Mixed linear model was used for length of stay (LOS) duration versus observed LOS. C-statistic was for predictive accuracy each binary outcome and intraclass correlation was used for LOS. RESULTS: C-statistic values were higher than the cutoff (0.75) for surgical site infection and death. The ACS NSQIP risk calculator was poorly predictive of other reported outcomes by the calculator such as cardiac or renal complications. Corroboration between observed LOS and predicted LOS was weak (8 d versus 11 d, respectively, intraclass coefficient 0.04). CONCLUSIONS: This study suggests that the risk calculator is useful for identifying risk of death or surgical site infection but poor at discriminating likelihood of other reported outcomes occurring, such as pneumonia, acute renal failure and cardiac complications for patients who underwent an Ivor Lewis esophagectomy. Estimations for procedure-specific complications for esophagectomy may need reevaluated.