Balloon-expandable cobalt chromium stent versus self-expandable nitinol stent for the Atherosclerotic Iliac Arterial Disease (SENS-ILIAC Trial) Trial: a randomized controlled trial.

Iliac artery angioplasty with stenting is an effective alternative treatment modality for aortoiliac occlusive diseases. Few randomized controlled trials have compared the efficacy and safety between self-expandable stent (SES) and balloon-expandable stent (BES) in atherosclerotic iliac artery disease. In this randomized, multicenter study, patients with common or external iliac artery occlusive disease were randomly assigned in a 1:1 ratio to either BES or SES. The primary end point was the 1-year clinical patency, defined as freedom from any surgical or percutaneous intervention due to restenosis of the target lesion after the index procedure. The secondary end point was a composite event from major adverse clinical events at 1 year. A total of 201 patients were enrolled from 17 major cardiovascular intervention centers in South Korea. The mean age of the enrolled patients was 66.8 ± 8.5 years and 86.2% of the participants were male. The frequency of critical limb ischemia was 15.4%, and the most common target lesion was in the common iliac artery (75.1%). As the primary end point, the 1-year clinical patency as primary end point was 99% in the BES group and 99% in the SES group (p > 0.99). The rate of repeat revascularization at 1 year was 7.8% in the BES group and 7.0% in the SES group (p = 0.985; confidence interval, 1.011 [0.341-2.995]). In our randomized study, the treatment of iliac artery occlusive disease with self-expandable versus balloon-expandable stent was comparable in 12-month clinical outcomes without differences in the procedural success or geographic miss rate regardless of the deployment method in the distal aortoiliac occlusive lesion (ClinicalTrials.gov, NCT01834495).

Mechanical properties, cytotoxicity, and protein adsorption of three-dimensionally printable hybrid resin containing zwitterionic polymer and silicate-based composites for dental restorations.

OBJECTIVE: To evaluate the mechanical and biological properties of three-dimensionally (3D) printable resins filled with 2-methacryloyloxyethyl phosphorylcholine (MPC) and silicate-based composites and compare with those of a commercially available 3D-printable resin for definitive restorations. METHODS: A group of 3D-printable hybrid resins (HRs) filled with 6 wt% MPC and three different compositions of silicate-based composites (barium silicate to zirconium silicate ratios: 1.50:1 for HR1, 0.67:1 for HR2, and 0.25:1 for HR3) were prepared. The HR groups were compared with the commercially available unfilled 3D-printable resin (CR) marketed for definitive restorations in terms of flexural strength and modulus, fracture toughness, surface roughness, Vickers hardness, light transmittance (all, n = 15), cytotoxicity, and protein adsorption (both, n = 3). All data were analyzed by using non-parametric Kruskal-Wallis and Dunn's tests (α=0.05). RESULTS: The HR groups had significantly higher flexural strength, modulus, fracture toughness, and hardness values than the CR (P < 0.001). HR3 had the highest surface roughness and light transmittance among the groups (P ≤ 0.006). None of tested resins showed cytotoxicity. Both HR2 and HR3 showed significantly lower protein adsorption than the CR, with a difference of approximately 60% (P ≤ 0.026). CONCLUSION: Both HR2 and HR3 exhibited superior mechanical properties (flexural strength, flexural modulus, fracture toughness, and Vickers hardness), light transmittance, and protein-repellent activity than the CR, with no impact on cytotoxicity. CLINICAL SIGNIFICANCE: The MPC/silicate-based composite-filled resins may be a suitable alternative for definitive restorations, given their higher mechanical properties and promising biological properties to prevent microbial adhesion and subsequent biofilm formation, as well as their non-cytotoxic properties.

Deep learning-designed implant-supported posterior crowns: Assessing time efficiency, tooth morphology, emergence profile, occlusion, and proximal contacts.

OBJECTIVES: To compare implant supported crowns (ISCs) designed using deep learning (DL) software with those designed by a technician using conventional computer-aided design software. METHODS: Twenty resin-based partially edentulous casts (maxillary and mandibular) used for fabricating ISCs were evaluated retrospectively. ISCs were designed using a DL-based method with no modification of the as-generated outcome (DB), a DL-based method with further optimization by a dental technician (DM), and a conventional computer-aided design method by a technician (NC). Time efficiency, crown contour, occlusal table area, cusp angle, cusp height, emergence profile angle, occlusal contacts, and proximal contacts were compared among groups. Depending on the distribution of measured data, various statistical methods were used for comparative analyses with a significance level of 0.05. RESULTS: ISCs in the DB group showed a significantly higher efficiency than those in the DM and NC groups (P ≤ 0.001). ISCs in the DM group exhibited significantly smaller volume deviations than those in the DB group when superimposed on ISCs in the NC group (DB-NC vs. DM-NC pairs, P ≤ 0.008). Except for the number and intensity of occlusal contacts (P ≤ 0.004), ISCs in the DB and DM groups had occlusal table areas, cusp angles, cusp heights, proximal contact intensities, and emergence profile angles similar to those in the NC group (P ≥ 0.157). CONCLUSIONS: A DL-based method can be beneficial for designing posterior ISCs in terms of time efficiency, occlusal table area, cusp angle, cusp height, proximal contact, and emergence profile, similar to the conventional human-based method. CLINICAL SIGNIFICANCE: A deep learning-based design method can achieve clinically acceptable functional properties of posterior ISCs. However, further optimization by a technician could improve specific outcomes, such as the crown contour or emergence profile angle.

Effect of postpolymerization time and atmosphere on surface properties and biofilm formation in additively manufactured resins for definitive restorations.

OBJECTIVES: To investigate how postpolymerization time (PPT) and atmosphere (PPA) influence the surface properties, protein adsorption, and microbial adhesion of two types of additively manufactured (AM) resins used for definitive restorations. METHODS: Two different types of commercially available AM resins for definitive restorations (UR and CR) were used to create disk-shaped specimens. These specimens were divided into eight groups based on resin type (UR and CR), PPT (standard or extended), and PPA (air or nitrogen). After postpolymerization, the surface roughness (Ra and Sa) and surface free energy (SFE) of all specimens were measured. The study also evaluated protein adsorption, microbial attachment, and cytotoxicity. A non-parametric factorial analysis of variance with post-hoc analyses was conducted, using a significance level (α) of 0.05. RESULTS: The Ra and Sa values for CR were higher than those for UR, regardless of PPT or PPA (P < 0.05). For UR, SFE was higher with extended PPT compared to standard PPT. CR had higher SFE than UR under standard PPT. The interaction between PPT and PPA had a significant effect on protein adsorption (P < 0.05). When PPT was standard, nitrogen significantly increased protein adsorption compared to air. The interaction between resin type and PPA, and between resin type and PPT, significantly affected microbial adhesion (P < 0.05). The changes in PPT or PPA did not affect the cytotoxicity of either AM resin. CONCLUSION: Surface properties, protein adsorption, and microbial attachment were influenced by the interactions among PPT, PPA, and resin type. These factors can have implications for resin-based definitive restorations. CLINICAL SIGNIFICANCES: Clinicians should understand the impact of PPT and PPA on the surface properties of AM resins for definitive restorations, particularly regarding protein adsorption and microbial adhesion. Additionally, the type of AM resin (based on chemical composition) could affect its biological properties.

Visualization of the existence of growth hormone secretagogue receptor in the rat nucleus accumbens.

The potential role of the ghrelin receptor, also known as the growth hormone secretagogue receptor (GHSR), within the nucleus accumbens (NAcc) in regulating drug addiction and feeding has been documented; however, the pattern of its expression in this site remains elusive. In this study, we characterized the expression patterns of GHSR1a and 1b, two subtypes of GHSRs, within the NAcc of the rat brain by immunohistochemistry. We visually detected GHSR signals, for the first time, at the protein level in the NAcc in which they were mostly expressed in neurons including both medium spiny neurons (MSNs) and non-MSNs. Furthermore, GHSR1a was found expressed as localized near the cellular membrane or some in the cytoplasm, whereas GHSR1b expressed solely throughout the large cytoplasmic area. The existence and subcellular expression pattern of GHSRs in the NAcc identified in this study will contribute to improving our understanding about the role of GHSR-mediated neurosignaling in feeding and drug addiction.

Quality controlled YouTube content intervention for enhancing health literacy and health behavioural intention: A randomized controlled study.

Background: Individuals increasingly turn to the Internet for health information, with YouTube being a prominent source. However, the quality and reliability of the health information vary widely, potentially affecting health literacy and behavioural intentions. Methods: To analyse the impact of health information quality on health literacy and behavioural intention, we conducted a randomized controlled trial using a quality-controlled YouTube intervention. Health information quality on YouTube was evaluated using the Global Quality Score and DISCERN. We randomly allocated (1 : 1) to the intervention group to watch the highest quality-evaluated content and to the control group to watch the lowest quality-evaluated content. Health literacy and health behavioural intention were assessed before and after watching YouTube. The trial was set for two different topics: interpreting laboratory test results from health check-up and information about inflammatory bowel disease (IBD). Results: From 8 April 2022 to 15 April 2022, 505 participants were randomly assigned to watch either high-quality content (intervention group, n = 255) or low-quality content (control group, n = 250). Health literacy significantly improved in the intervention group (28.1 before and 31.8 after; p < 0.01 for health check-up; 28.3 before and 31.3 after; p < 0.01 for IBD). Health behavioural intention significantly improved in the intervention group (3.5 before and 4.1 after; p < 0.01 for health check-up; 3.6 before and 4.0 after; p < 0.01 for IBD). Control groups had no such effect. Conclusion: High-quality health information can enhance health literacy and behavioural intention in both healthy individuals and those with specific conditions like IBD. It stresses the significance of ensuring reliable health information online and calls for future efforts to curate and provide access to high-quality health content.

Effect of barium silicate on mechanical properties, transmittance, and protein adsorption of resin for additive manufacturing containing zwitterionic polymer.

STATEMENT OF PROBLEM: Studies on the effect of barium silicate on the material properties of additively manufactured (AM) resins containing 2-methacryloyloxyethyl phosphorylcholine (MPC) for dental applications are lacking. PURPOSE: The purpose of this in vitro study was to evaluate the mechanical properties, transmittance, and protein adsorption of MPC-containing AM resin incorporated with different barium silicate contents and to compare these findings with those of a commercially available unfilled AM resin marketed for definitive restorations. MATERIAL AND METHODS: Resins incorporating 6 wt% MPC and 4 different concentrations of barium silicate (10 wt%, MB10; 20 wt%, MB20; 30 wt%, MB30; and 40 wt%, MB40) were prepared. An MPC-containing resin with no filler was also prepared (0 wt%, MBN). Surface roughness (n=15), Vickers hardness (n=15), flexural strength and modulus (n=15), fracture toughness (n=15), transmittance (n=15), and protein adsorption (n=3) of the filled resin specimens were measured and compared with those of commercially available unfilled resin specimens. All data were analyzed using the Kruskal-Wallis and Dunn tests (α=.05). RESULTS: All experimental resins had higher surface roughness than the unfilled resin (P≤.048). MB40 had higher hardness, flexural strength, flexural modulus, and fracture toughness than most other groups (P≤.047). MB10 had higher transmittance than most other groups (P≤.012). All experimental resins had lower protein adsorption than the unfilled resin, regardless of the barium silicate content (P≤.023). CONCLUSIONS: The experimental resin containing 6 wt% MPC and 40 wt% barium silicate showed better mechanical properties and lower protein adsorption than the resin with no MPC or ceramic fillers. Transmittance decreased with the increase of barium silicate in the resins.

Complete Digital Workflow for Fabricating an Occlusal Device Using Artificial Intelligence- Powered Design Software and Additive Manufacturing: A Dental Method.

Artificial intelligence (AI) has been expanding into areas that were thought to be reserved for human experts and has a tremendous potential to improve patient care and revolutionize the healthcare field. Recently launched AI-powered dental design solutions enable automated occlusal device design. This article describes a dental method for the complete digital workflow for occlusal device fabrication using two different AIpowered design software programs (Medit Splints and 3Shape Automate) and additive manufacturing. Additionally, the benefits and drawbacks of this workflow were reviewed and compared to conventional workflows.

Association of midlife body-weight variability and cycles with earlier dementia onset: a nationwide cohort study.

BACKGROUND: Given the rising awareness of health-related lifestyle modifications, the impact of changes in body weight (BW) on cognitive function and dementia generates significant concern. This study aimed to investigate the association between BW changes and dementia in a middle-aged Korean population. METHODS: A retrospective, population-based longitudinal study was conducted utilizing data from the National Health Insurance Service (NHIS) database. Participants aged 40 years or older in 2011 who underwent at least five health checkups between 2002 and 2011 were followed-up for dementia until 2020. A total of 3,635,988 dementia-free Korean aged < 65 at baseline were examined. We analyzed the association between BW variability independent of the mean (VIM) with BW cycle, defined as either an upward or a downward direction of BW, and the risk of incident dementia. RESULTS: The results showed an increased risk of dementia in the highest quartile of VIM quartile (hazard ratio [HR] 1.52, 95% confidence interval [CI] 1.47-1.58) compared to the lowest quartile of VIM. Additionally, the results showed an even higher increased risk of dementia in the highest BW cycle (≥ 2 cycles of 10% BW = HR 2.00, 95% CI 1.74-1.29). Notably, the combined concept of VIM with BW cycle showed an even higher dementia risk (highest quartile of VIM with ≥ 2 cycles of 10% BW = HR 2.37, 95% CI 2.05-2.74) compared to the baseline group (lowest quartile of VIM with < 3% BW cycle). CONCLUSIONS: The present study highlights the importance of considering BW changes with BW variability along with the BW cycle to assess dementia risk in detail, providing valuable insights for preventive strategies.

Double-Shelled Fe-Fe3C Nanoparticles Embedded on a Porous Carbon Framework for Superior Lithium-Ion Half/Full Batteries.

Cost-effective and environmentally friendly Fe-based active materials offer exceptionally high energy capacity in lithium-ion batteries (LIBs) due to their multiple electron redox reactions. However, challenges, such as morphology degradation during cycling, cell pulverization, and electrochemical stability, have hindered their widespread use. Herein, we demonstrated a simple salt-assisted freeze-drying method to design a double-shelled Fe/Fe3C core tightly anchored on a porous carbon framework (FEC). The shell consists of a thin Fe3O4 layer (≈2 nm) and a carbon layer (≈10 nm) on the outermost part. Benefiting from the complex nanostructuring (porous carbon support, core-shell nanoparticles, and Fe3C incorporation), the FEC anode delivered a high discharge capacity of 947 mAh g-1 at 50 mA g-1 and a fast-rate capability of 305 mAh g-1 at 10 A g-1. Notably, the FEC cell still showed 86% reversible capacity retention (794 mAh g-1 at 50 mA g-1) at a high cycling temperature of 80 °C, indicating superior structural integrity during cycling at extreme temperatures. Furthermore, we conducted a simple solid-state fluorination technique using the as-prepared FEC sample and excess NH4F to prepare iron fluoride-carbon composites (FeF2/C) as the positive electrode. The full cell configuration, consisting of the FEC anode and FeF2/C cathode, reached a remarkable capacity of 200 mAh g-1 at a 20 mA g-1 rate or an energy density of approximately 530 Wh kg-1. Thus, the straightforward and simple experimental design holds great potential as a revolutionary Fe-based cathodic-anodic pair candidate for high-energy LIBs.

Persistent poverty disparities in incidence and outcomes among oral and pharynx cancer patients.

PURPOSE: Disparities in oral cavity and pharyngeal cancer based on race/ethnicity and socioeconomic status have been reported, but the impact of living within areas that are persistently poor at the time of diagnosis and outcome is unknown. This study aimed to investigate whether the incidence, 5-year relative survival, stage at diagnosis, and mortality among patients with oral cavity and pharyngeal cancers varied by persistent poverty. METHODS: Data were drawn from the SEER database (2006-2017) and included individuals diagnosed with oral cavity and pharyngeal cancers. Persistent poverty (at census tract) is defined as areas where ≥ 20% of the population has lived below the poverty level for ~ 30 years. Age-adjusted incidence and 5-year survival rates were calculated. Multivariable logistic regression was used to estimate the association between persistent poverty and advanced stage cancer. Cumulative incidence and multivariable subdistribution hazard models were used to evaluate mortality risk. In addition, results were stratified by cancer primary site, sex, race/ethnicity, and rurality. RESULTS: Of the 90,631 patients included in the analysis (61.7% < 65 years old, 71.6% males), 8.8% lived in persistent poverty. Compared to non-persistent poverty, patients in persistent poverty had higher incidence and lower 5-year survival rates. Throughout 10 years, the cumulative incidence of cancer death was greater in patients from persistent poverty and were more likely to present with advanced-stage cancer and higher mortality risk. In the stratified analysis by primary site, patients in persistent poverty with oropharyngeal, oral cavity, and nasopharyngeal cancers had an increased risk of mortality compared to the patients in non-persistent poverty. CONCLUSION: This study found an association between oral cavity and pharyngeal cancer outcomes among patients in persistent poverty indicating a multidimensional strategy to improve survival.

Iron homeostasis in older adults: balancing nutritional requirements and health risks.

Iron plays a crucial role in many physiological processes, including oxygen transport, bioenergetics, and immune function. Iron is assimilated from food and also recycled from senescent red blood cells. Iron exists in two dietary forms: heme (animal based) and non-heme (mostly plant based). The body uses iron for metabolic purposes, and stores the excess mainly in splenic and hepatic macrophages. Physiologically, iron excretion in humans is inefficient and not highly regulated, so regulation of intestinal absorption maintains iron homeostasis. Iron losses occur at a steady rate via turnover of the intestinal epithelium, blood loss, and exfoliation of dead skin cells, but overall iron homeostasis is tightly controlled at cellular and systemic levels. Aging can have a profound impact on iron homeostasis and induce a dyshomeostasis where iron deficiency or overload (sometimes both simultaneously) can occur, potentially leading to several disorders and pathologies. To maintain physiologically balanced iron levels, reduce risk of disease, and promote healthy aging, it is advisable for older adults to follow recommended daily intake guidelines and periodically assess iron levels. Clinicians can evaluate body iron status using different techniques but selecting an assessment method primarily depends on the condition being examined. This review provides a comprehensive overview of the forms, sources, and metabolism of dietary iron, associated disorders of iron dyshomeostasis, assessment of iron levels in older adults, and nutritional guidelines and strategies to maintain iron balance in older adults.

Fabrication trueness and marginal quality of additively manufactured resin-based definitive laminate veneers with different restoration thicknesses.

OBJECTIVES: To evaluate how restoration thickness (0.5 mm and 0.7 mm) affects the fabrication trueness of additively manufactured definitive resin-based laminate veneers, and to analyze the effect of restoration thickness and margin location on margin quality. METHODS: Two maxillary central incisors were prepared either for a 0.5 mm- or 0.7 mm-thick laminate veneer. After acquiring the partial-arch scans of each preparation, laminate veneers were designed and stored as reference data. By using these reference data, a total of 30 resin-based laminate veneers were additively manufactured (n = 15 per thickness). All veneers were digitized and stored as test data. The reference and test data were superimposed to calculate the root mean square values at overall, external, intaglio, and marginal surfaces. The margin quality at labial, incisal, mesial, and distal surfaces was evaluated. Fabrication trueness at each surface was analyzed with independent t-tests, while 2-way analysis of variance was used to analyze the effect of thickness and margin location on margin quality (α = 0.05). RESULTS: Regardless of the evaluated surface, 0.7 mm-thick veneers had lower deviations (P < 0.001). Only the margin location (P < 0.001) affected the margin quality as labial margins had the lowest quality (P < 0.001). CONCLUSION: Restoration thickness affected the fabrication trueness of resin-based laminate veneers as 0.7 mm-thick veneers had significantly higher trueness. However, restoration thickness did not affect the margin quality and labial margins had the lowest quality. CLINICAL SIGNIFICANCE: Laminate veneers fabricated by using tested urethane-based acrylic resin may require less adjustment when fabricated in 0.7 mm thickness. However, marginal integrity issues may be encountered at the labial surface.

Sodium Intake and Cause-Specific Mortality Among Predominantly Low-Income Black and White US Residents.

IMPORTANCE: Epidemiologic evidence regarding the outcomes of dietary sodium intake on mortality remains limited for low-income individuals, particularly Black people. OBJECTIVE: To investigate the associations of excessive dietary sodium with all-cause and cause-specific mortality among predominantly low-income Black and White Americans. DESIGN, SETTING, AND PARTICIPANTS: This cohort study included participants aged 40 to 79 years from the Southern Community Cohort Study who were recruited at Community Health Centers in 12 southeastern states from 2002 to 2009. Analyses were conducted between March 2022 and June 2023. EXPOSURES: Dietary sodium intake was assessed using a validated food frequency questionnaire at baseline. MAIN OUTCOMES AND MEASURES: Multivariable-adjusted Cox regression was used to estimate hazard ratios (HRs) and 95% CIs for mortality outcomes (all-cause, cardiovascular disease [CVD], coronary heart disease [CHD], stroke, heart failure, cancer, and other) associated with sodium intake. Nonlinear associations and population-attributable risk (PAR) of the mortality burden associated with excess sodium were further assessed. RESULTS: Among the 64 329 participants, 46 185 (71.8%) were Black, 18 144 (28.2%) were White, and 39 155 (60.9%) were female. The mean (SD) age at study enrollment was 51.3 (8.6) years for Black participants and 53.3 (9.3) years for White counterparts. Mean (SD) dietary sodium intake was 4512 (2632) mg/d in Black individuals and 4041 (2227) mg/d in White individuals; 37 482 Black individuals (81.2%) and 14 431 White individuals (79.5%) exceeded the current dietary recommendations of 2300 mg/d. During a median (IQR) follow-up of 13.8 (11.3-15.8) years, 17 811 deaths were documented, including 5701 from CVD. After adjustment for potential confounders, in Black individuals, HRs per 1000-mg increase in daily sodium intake were 1.07 (95% CI, 1.03-1.10) and 1.08 (95% CI, 1.02-1.14) for deaths from total CVD and CHD, respectively; while in White individuals, the corresponding HRs were 1.08 (95% CI, 1.02-1.14) and 1.13 (95% CI, 1.03-1.23). No significant associations were found for cancer mortality. PAR estimates suggest that sodium intake above the recommended threshold may account for 10% of total CVD, 13% of CHD, and 30% of heart failure deaths in this low-income southern population. CONCLUSIONS AND RELEVANCE: In this cohort study of 64 329 low-income Americans, nearly 80% of study participants consumed sodium exceeding the current recommended daily amount, which was associated with 10% to 30% of CVD mortality. Public health programs targeted to reduce sodium intake among this underserved population may be beneficial.

Comparison of survival outcome of open, total laparoscopic, and laparoscopy-assisted radical vaginal hysterectomy for stage IB2 cervical cancer patients: A multicenter retrospective study.

The aim of this study was to compare survival outcomes of 3 different radical hysterectomy (RH) types, namely total abdominal radical hysterectomy (TARH), total laparoscopic radical hysterectomy (TLRH), and laparoscopy-assisted radical vaginal hysterectomy (LARVH), in patients with FIGO stage IB2 cervical cancer. We retrospectively identified a cohort of patients who underwent RH for cervical cancer between 2010 and 2017. Patients with stage IB2 cervical cancer were included and were classified into TARH, TLRH, and LARVH treatment groups. Survival outcomes were estimated by the Kaplan-Meier method and compared with the log-rank test. Cox proportional hazards models were fit to estimate the independent association of RH technique with outcome. 194 patients were included in this study: 79 patients in the TARH group, 55 in the TLRH group, and 60 in the LARVH group. No significant differences were found in clinicopathological characteristics between the 3 RH groups. On comparing survival outcomes with TARH, both TLRH and LARVH showed no significant difference in terms of 5-year overall survival (TARH vs TLRH, P = .121 and TARH vs LARVH, P = .436). Conversely, compared to the TARH group, 5-year progression-free survival (PFS) was significantly worse in the TLRH group (P = .034) but not in the LARVH group (P = .288). Multivariate analysis showed that TLRH surgical approach (hazard ratio, 3.232; 95% confidence interval, 1.238-8.438; P = .017) was an independent prognostic factor for PFS in patients with IB2 cervical cancer. Our study suggests that in patients with FIGO stage IB2 cervical cancer, among the minimally invasive RH approaches, TLRH and LARVH, only TLRH approach was associated with worse PFS when compared with the TARH approach.

Continual learning framework for a multicenter study with an application to electrocardiogram.

Deep learning has been increasingly utilized in the medical field and achieved many goals. Since the size of data dominates the performance of deep learning, several medical institutions are conducting joint research to obtain as much data as possible. However, sharing data is usually prohibited owing to the risk of privacy invasion. Federated learning is a reasonable idea to train distributed multicenter data without direct access; however, a central server to merge and distribute models is needed, which is expensive and hardly approved due to various legal regulations. This paper proposes a continual learning framework for a multicenter study, which does not require a central server and can prevent catastrophic forgetting of previously trained knowledge. The proposed framework contains the continual learning method selection process, assuming that a single method is not omnipotent for all involved datasets in a real-world setting and that there could be a proper method to be selected for specific data. We utilized the fake data based on a generative adversarial network to evaluate methods prospectively, not ex post facto. We used four independent electrocardiogram datasets for a multicenter study and trained the arrhythmia detection model. Our proposed framework was evaluated against supervised and federated learning methods, as well as finetuning approaches that do not include any regulation to preserve previous knowledge. Even without a central server and access to the past data, our framework achieved stable performance (AUROC 0.897) across all involved datasets, achieving comparable performance to federated learning (AUROC 0.901).

Effect of Hydrothermal Aging on the Flexural Strength and Microhardness of Materials Used for Additive or Subtractive Manufacturing of Definitive Restorations.

PURPOSE: To evaluate the flexural strength (FS) and microhardness of various CAD/CAM restorative materials intended for definitive use. The effect of hydrothermal aging on the mechanical properties of these materials was also investigated. MATERIALS AND METHODS: A total of 210 bar-shaped specimens (17 × 4 × 1.5 mm ± 0.02 mm) were fabricated via either subtractive manufacturing (SM) methods-reinforced composite resin (SM-CR), polymer-infiltrated ceramic network (SM-PICN), fine-structured feldspathic ceramic (SMFC), nanographene-reinforced polymethyl methacrylate (PMMA; SM-GPMMA), PMMAbased resin (SM-PMMA)-or additive manufacturing (AM) methods with urethane acrylate-based resins (AM-UA1 and AM-UA2). Specimens were then divided into two subgroups (nonaged or hydrothermal aging; n = 15). A three-point flexural strength test was performed, and five specimens from the nonaged group were submitted to microhardness testing. Specimens were subjected to 10,000 thermal cycles, and the measurements were repeated. RESULTS: Regardless of aging, SM-CR had the highest FS (P < .001), followed by SM-GPMMA (P ≤ .042). In nonaged groups, AM-UA2 had a lower FS than all other materials except SM-FC (P = 1.000). In hydrothermal aging groups, AM specimens had lower FS values than other materials, except SM-PMMA. With regard to microhardness, there was no significant difference found between any of the tested materials (P ≥ .945) in the nonaged and hydrothermal aging groups. CONCLUSIONS: The effect of hydrothermal aging on FS varied depending on the type of restorative material. Regardless of aging condition, SM-CR showed the highest FS values, whereas SM-FC had the highest microhardness. Hydrothermal aging had no significant influence on the microhardness of the tested materials.

Effect of Polymerization Unit, Polishing, and Coffee Thermocycling on the Color and Translucency of Additively Manufactured Resins Used for Definitive Prostheses.

PURPOSE: To evaluate the effect of polymerization unit, polishing, and coffee thermocycling on the color and translucency of additively manufactured polyurethane-based resins with different viscosities. In addition, their color behavior was compared with the color of the shade tab throughout the fabrication steps and aging. MATERIALS AND METHODS: Disk-shaped specimens (Ø10 × 2 mm) were fabricated from polyurethane-based resins with different viscosities (Tera Harz TC-80DP and C&B permanent; n = 30 per material). Baseline color coordinates were measured after cleaning. The specimens in each resin group were divided into three subgroups (n = 10 per subgroup) to be polymerized with different polymerization units (Otoflash G171 [FLN], Wash and Cure 2.0 [CLED1], and P Cure [CLED2]), polished, and subjected to coffee thermocycling. Color coordinates were remeasured after each process. Color differences (ΔE00) and relative translucency parameter (RTP) values were calculated. Data were statistically analyzed (α = .05). RESULTS: Time points and polymerization units affected the ΔE00 for each material (P ≤ .049). ΔE00 of each polymerization unit pair had significant differences within and among different time points within each material (P ≤ .024). ΔE00 (when compared with the shade tab) and RTP were mostly affected by polymerization units and time points within both materials (P ≤ .042). CONCLUSIONS: Tested polymerization units, polishing, and coffee thermocycling affected the color difference and translucency of tested resins. Color differences ranged from moderately unacceptable to extremely unacceptable, and the differences in translucency values mostly ranged from perceptible to unacceptable, according to previous thresholds. In addition, tested resin-polymerization unit pairs had unacceptable color differences when compared to the shade tab. CLED1 may enable higher color stability for tested resins.

Development of a Risk Score to Predict Short-term Smoking Relapse Following an Inpatient Smoking Cessation Intervention.

This study aimed to investigate the factors affecting smoking relapse and to develop predictive models among Korean national 5-day smoking cessation program participants. The subjects were 518 smokers and follow-up was continued for 6 months after discharge. A predictive logistic model and risk score were developed from the multivariate logistic models and compared using the area under the receiver operating characteristic curve (area under the curve [AUC]). The smoking relapse rate within 6 months after program participation was 38.4%. The AUCs of the logistic regression model and risk score model were similar (odds ratio [OR] = 0.69; 0.69, respectively) in the development data set, and those of the risk score model were similar between the development and validation data sets (OR = 0.68). The risk score used by the six risk factors could predict smoking relapse among participants who attended a 5-day inpatient smoking cessation program.

The Impact of Oxygen Concentration on the Postcuring of 3D-Printed Dental Resin.

PURPOSE: This study investigated the impact of reducing the oxygen concentration via nitrogen injection during the postcuring process of 3D-printed dental materials. MATERIALS AND METHODS: Resin specimens for dental crown and bridge (15-mm diameter, both 1-mm and 2-mm heights) were 3D-printed and rinsed. Subsequently, the postcuring process was conducted on nine groups categorized according to atmospheric conditions within the curing device (20% [control], 10%, and 5% oxygen) and curing times (10, 15, and 20 minutes). Surface roughness was measured using a gloss meter. Surface polymerization was confirmed through Fourier-transform infrared spectroscopy (FT-IR) analysis, and the flexural strength and elastic modulus of the specimens were measured using a universal testing machine. Water absorption and solubility were determined according to Inernational Organization for Standardization (ISO) standards. All evaluation criteria were statistically analyzed using one-way ANOVA and Tukey's post hoc test based on oxygen concentration. RESULTS: The elastic modulus did not show statistically significant differences in all groups. However, compared to the control group, the flexural strength, degree of conversion, and gloss significantly increased in the groups with decreased oxygen concentrations. Conversely, water solubility and water absorption significantly decreased in a few groups with reduced oxygen concentration. CONCLUSIONS: Reducing oxygen concentration through nitrogen injection during the postcuring process of 3D printing enhances the suitability of the dental prosthetic materials. The significant increase in flexural strength can particularly enhance the utility of these materials in dental prosthetics.