Comparative analysis of enzymatic profiles and biofilm formation in clinical and environmental Candida kefyr isolates.

The global landscape of Candida infections has seen a significant shift. Previously, Candida albicans was the predominant species. However, there has been an emergence of non-albicans Candida species, which are often less susceptible to antifungal treatment. Candida kefyr, in particular, has been increasingly associated with infections. This study aimed to investigate the profiles of enzymatic activity and biofilm formation in both clinical and non-clinical isolates of C. kefyr. A total of 66 C. kefyr isolates were analysed. The activities of proteinase and phospholipase were assessed using bovine serum albumin and egg yolk agar, respectively. Haemolysin, caseinolytic and esterase activities were evaluated using specific methods. Biofilm formation was investigated using crystal violet staining. The findings indicated that biofilm and proteinase activity were detected in 81.8% and 93.9% of all the isolates, respectively. Haemolysin activity was observed with the highest occurrence (95.5%) among normal microbiota isolates. Esterase activity was predominantly identified in dairy samples and was absent in hospital samples. Caseinase production was found with the highest occurrence (18.2%) in normal microbiota and hospital samples. Phospholipase activity was limited, found in only 3% of all the isolates. These findings reveal variations in enzyme activity between clinical and non-clinical C. kefyr isolates. This sheds light on their pathogenic potential and has implications for therapeutic strategies.

Three-Dimensionally Printed Self-Lock Origami: Design, Fabrication, and Simulation to Improve Performance of Rotational Joint.

Origami structures have made significant contributions to the field of robotics, offering various advantages. One such advantage is their ability to conserve space by transforming the structure into a compact form. Additionally, many origami structures can be fabricated in a flat state to simplify manufacturing, giving them the potential for large-scale and cost-effective production. Rotational joints play a crucial role in the construction of robotic systems, yet origami rotational joints can suffer from a limited range of motion. We previously theoretically proposed the Self-Lock Joint to address this issue, but it is only partially flat-foldable. This paper presents a novel approach to the 3D printing of modular origami joints, such as the Self-Lock Joint, using 3D-printed plates joined with a fabric layer. The compliance of the fabric can improve the joint's semi flat-foldability or even enable it to achieve complete flat-foldability. Furthermore, the rotational motion of the joint is enhanced, allowing for close to 360 degrees of rotational movement. We assess the physical properties of the joint under both loaded and unloaded conditions in order to identify design trade-offs in the physical properties of the joints. Moreover, as a proof of concept, we construct and demonstrate manipulators utilizing these joints. The increase in rotational movement enabled by this fabrication method, coupled with the compliant joint's flat-foldability and modular nature, make it a promising candidate for use in a wide range of applications.

Analyzing Trends in Demographic, Laboratory, Imaging, and Clinical Outcomes of ICU-Hospitalized COVID-19 Patients.

Background: COVID-19 has led to significant hospitalization and intensive care unit admission rates. The demographic parameters of COVID-19 patients, such as age, underlying illnesses, and clinical symptoms, substantially influence the incidence and mortality of these individuals. The current study examined the clinical and demographic characteristics of COVID-19 intensive care unit (ICU) patients in Yazd, Iran. Methods: The descriptive-analytical cross-sectional study was conducted on ICU patients with a positive RT-PCR test for coronavirus, admitted to the ICU in Yazd province, Iran, over 18 months. To this end, demographic, clinical, laboratory, and imaging data were collected. Moreover, patients were divided into good and worse clinical outcome groups based on their clinical outcomes. Subsequently, data analysis was performed at a 95% confidence interval (CI) using SPSS 26 software. Results: 391 patients with positive PCR were analyzed. The average age of the patients in the study was 63.59 ± 17.76, where 57.3% were male. On the high-resolution computed tomography (HRCT) scan, the mean lung involvement score was 14.03 ± 6.04, where alveolar consolidation (34%) and ground-glass opacity (25.6%) were the most prevalent type of lung involvement. The most common underlying illnesses in the study participants were hypertension (HTN) (41.4%), diabetes mellitus (DM) (39.9%), ischemic heart disease (IHD) (21%), and chronic kidney disease (CKD) (20.7%). In hospitalized patients, the rates of endotracheal intubation and mortality were 38.9% and 38.1%, respectively. Age, DM, HTN, dyslipidemia, CKD, cerebral vascular accident (CVA), cerebral hemorrhage, and cancer were reported to be significantly different between these two groups of patients, indicating an increase in the rate of intubation and mortality among these patients. Furthermore, the multivariate logistic regression analysis revealed that DM, HTN, CKD, CVA, neutrophil-to-lymphocyte ratio (NLR), the percentage of lung involvement, and initial O2 saturation significantly increase the mortality of ICU patients. Conclusion: Several features of COVID-19 patients influence the mortality in these individuals. According to the findings, early detection of this disease in people at high risk of death can prevent its progression and lower mortality rates.

Efficacy and safety of Tocilizumab, plasmapheresis and their combination in severe COVID-19: A randomized clinical trial.

BACKGROUND: This study sought to evaluate and compare the effectiveness of plasmapheresis, Tocilizumab, and Tocilizumab with plasmapheresis treatment on the removal of inflammatory cytokines and improvement clinically of patients with severe COVID-19 in Intensive Care Units (ICU) due to the association between increased cytokine release and the severity of COVID-19. METHODS: This clinical trial study was conducted in three treatment arms in Iran. All patients received standard care and randomization into one of three treatment groups; Tocilizumab (TCZ) alone, plasmapheresis alone, or a combination of Tocilizumab and plasmapheresis. Demographics, clinical evaluation, oxygenation status, laboratory tests and imaging data were evaluated in the three groups and re-checked 48 h after the end of treatment trials. Primary outcomes were oxygenation status, the need for mechanical ventilation and the rate of death. RESULTS: Ninety-four patients were included in the trial after meeting the eligibility requirements. Twenty-eight patients received Tocilizumab alone, 33 had plasmapheresis alone, and 33 received both Tocilizumab and plasmapheresis. Baseline characteristics did not differ between three groups that included demographic, clinical and laboratory parameters. Following therapy, there was no difference between the three groups for CRP, ferritin, d-dimer, IL-6, pro-calcitonin and neutrophil to lymphocyte ratio (NLR) (P > 0.05). While a significant reduction was found in CRP levels within each group (32.04 ± 42.43 to 17.40 ± 38.11, 51.28 ± 40.96 to 26.36 ± 33.07 and 41.20 ± 34.27 to 21.56 ± 24.96 in the tocilizumab, plasmapheresis, and combined group, respectively) (p < 0.05), procalcitonin levels were elevated significantly in the Tocilizumab group (0.28 ± 0.09 to 0.37 ± 0.11) (p < 0.05). Clinically there was no difference between the three groups following treatment for O2 saturation levels with supplementary oxygen at discharge, endotracheal intubation rate, use of NIVPP, mortality, mean hospital and ICU length of stay (p > 0.05). CONCLUSION: Study results showed that the reduction of serum inflammatory markers, the rate of intubation and therapeutic complications including death were no different between the three groups; however, CRP levels were significantly reduced in all three groups, indicating that the interventions reduced inflammation likely through a reduction in the cytokine storm, though clinical outcomes were unaffected.

Prognostic value and optimal threshold of first thyroglobulin in low/intermediate risk DTC.

BACKGROUND: The aim of this study was to define prognostic value and optimal threshold of first thyroglobulin (fTg) measured after thyroidectomy and just before radio-iodine therapy (RIT), in low/intermediate risk patients with differentiated thyroid cancer (DTC). METHODS: This is a retrospective study in 383 patients with DTC who were treated with surgery followed by RIT. Response to treatment was assessed 1 and 2 years after RIT. Odds ratio of different risk factors like age, sex, TNM stage, fTg and Anti-Tg Ab were compared between patients with and without incomplete response 1 and 2 years after treatment. Receiver operating curve analysis was used for definition of optimal fTg cut off for detection of incomplete response. RESULTS: 218 female and 55 male with DTC had negative anti-Tg antibody (mean age: 37.5±14.5 years) and analyzed separately. fTg≥33.5 ng/mL and fTg/TSH ratio of ≥0.36 had the optimal sensitivity and specificity for detection of incomplete response 1 and 2 years after treatment. fTg<33.5 ng/mL had NPV of 98.5% for exclusion of distant metastases. Patients with fTg≥33.5 ng/mL had longer "time to excellent response" (3.6±2.3 vs. 2.0±1.8 yrs) and needed more additional treatments compared to patients with fTg<33.5 ng/mL. Multivariate analysis showed that fTg was the most potent risk factor for prediction of treatment failure 1 and 2 years after RIT. CONCLUSIONS: fTg of ≥33.5 ng/mL was the most important risk factor for prediction of treatment failure after RIT and could be included in decision algorithms regarding intensity of treatments in low/intermediate risk patients with DTC.

Simultaneous fault diagnosis of wind turbine using multichannel convolutional neural networks.

Wind turbine technology is pursuing the maturation using advanced multi-megawatt machinery equipped by powerful monitoring systems. In this work, a multichannel convolutional neural network is employed to develop an autonomous databased fault diagnosis algorithm. This algorithm has been evaluated in a 5MW wind turbine benchmark model. Several faults for various wind speeds are simulated in the benchmark model, and output data are recorded. A multichannel convolutional neural network with multiple parallel local heads is utilized in order to consider changes in every measured variable separately to identify subsystem faults. Time-domain signals obtained from the wind turbine are portrayed as images and fed independently to the proposed network. Results show that the multivariable fault diagnosis scheme diagnoses the most common wind turbine faults and achieves high accuracy.

Fracture resistance of structurally compromised premolar roots restored with single and accessory glass or quartz fiber posts.

BACKGROUND: Glass and quartz fiber posts are used in restoration of structurally compromised roots. Accessory fiber posts are recently introduced to enhance the fiber post adaptation. This study evaluated the effectiveness of glass versus quartz accessory fiber posts. MATERIALS AND METHODS: In this experimental study, 40 mandibular premolar roots with similar dimension (radius of 3.5 ± 0.2 mm and length of 13 ± 0.5 mm) were selected and their root canals were flared until 1.5 mm of dentin wall remained. They were randomly assigned to four groups (n = 10) and restored as follows: Exacto glass fiber post (EX), Exacto glass fiber post + 2 Reforpin accessories (EXR), D. T. Light quartz fiber post (DT), and D. T. Light quartz fiber post + 2 Fibercone accessories (DTF). All posts were cemented with Duo-Link resin cement and the cores were built with the particulate filler composite. Following 1-week water storage, specimens were subjected to fracture loads in a universal testing machine. The maximum loads and failure modes were recorded and analyzed with the two-way analysis of variance (ANOVA) and Fisher's exact tests (α = 0.05). RESULTS: The mean fracture resistance values (N) were 402.8 (EX), 378.4 (EXR), 400.1 (DT), and 348.5 (DTF). Two-way ANOVA test showed neither reinforcing method (P = 0.094), nor post composition (P = 0.462) had statistically significant differences on fracture resistance of the structurally compromised premolar teeth. Fisher's exact test also demonstrated no statistically significant difference regarding two variables (P = 0.695). Core fracture was the most common failure mode (62.5%). CONCLUSION: Glass and quartz fiber posts with or without accessories restored the weakened premolar roots equally.

Do angulated implants increase the amount of bone loss around implants in the anterior maxilla?

PURPOSE: The aim of this study was to evaluate the relation between angulated implants and the bone loss around implants in the anterior maxilla. MATERIALS AND METHODS: The subjects studied had a missing tooth in the anterior maxilla and a bone deficiency that required restoration with an angulated dental implant. After mounting the casts on the articulator, the amount of direction was measured with a facebow by calculating the difference between the mean buccopalatal angulation of the 2 adjacent natural teeth and the buccopalatal angulation of the implant abutment to the occlusal plane. Radiography was performed in each patient immediately after loading and repeated a minimum of 36 months after loading. RESULTS: Fifty-eight subjects who received delayed-loading angulated implants were studied. The results showed that the mean implant angulation was 15.2° and the mean bone resorption was 0.87 mm. Analysis of the data showed a significant correlation between implant follow-up time and bone loss. No correlation was seen between the implant angulation and bone loss. An assessment of predictive factors showed a relation between the implant type and bone loss. The follow-up time had a significant effect on bone loss. The implant angulation did not change bone resorption on the mesial and distal surfaces of the implants. CONCLUSIONS: The angulation of implants was not associated with an increased risk for bone loss, and angulated implants may be a satisfactory alternative to vertical implants to avoid grafting procedures. The type of implant may be an important factor that affects bone resorption, although follow-up time was the strongest predictive factor.

Effect of Home Bleaching on Microleakage of Fiber-reinforced and Particle-filled Composite Resins.

Background and aims. Bleaching may exert some negative effects on existing composite resin restorations. The aim of this study was to evaluate the effect of home bleaching on microleakage of fiber-reinforced and particle-filled composite resins. Materials and methods. Ninety class V cavities (1.5×2×3 mm) were prepared on the buccal surfaces of 90 bovine teeth. The teeth were randomly divided into 6 groups (n=15) and restored as follows: Groups 1 and 2 with Z100, groups 3 and 4 with Z250, and groups 5 and 6 with Nulite F composite resins. All the specimens were thermocycled. Groups 1, 3 and 5 were selected as control groups (without bleaching) and the experimental groups 2, 4 and 6 were bleached with 22% carbamide peroxide gel. All the samples were immersed in 2% basic fuchsin dye for 24 hours and then sectioned longitudinally. Dye penetration was evaluated under a stereomicroscope (×25), at both the gingival and incisal margins. Data were analyzed using Kruskal-Wallis, Mann-Whitney and Wilcoxon tests (a=0.05). Results. Statistical analyses revealed that bleaching gel increased microleakage only at gingival margins with Z250 (P=0.007). Moreover, the control groups showed a statistically significant difference in microleakage at their gingival margins. Nulite F had the maximum microleakage while Z250 showed the minimum (P=0.006). Conclusion. Microleakage of home-bleached restorations might be related to the type of composite resin used.

Effect of open rhinoplasty on the smile line.

PURPOSE: Open rhinoplasty is an esthetic surgical technique that is becoming increasingly popular, and can affect the nose and upper lip compartments. The aim of this study was to evaluate the effect of open rhinoplasty on tooth show and the smile line. PATIENTS AND METHODS: The study participants were 61 patients with a mean age of 24.3 years (range, 17.2 to 39.6 years). The surgical procedure consisted of an esthetic open rhinoplasty without alar resection. Analysis of tooth show was limited to pre- and postoperative (at 12 months) tooth show measurements at rest and the maximum smile with a ruler (when participants held their heads naturally). Statistical analyses were performed with SPSS 13.0, and paired-sample t tests were used to compare tooth show means before and after the operation. RESULTS: Analysis of the rest position showed no statistically significant change in tooth show (P = .15), but analysis of participants' maximum smile data showed a statistically significant increase in tooth show after surgery (P < .05). In contrast, Pearson correlation analysis showed a positive relation between rhinoplasty and tooth show increases in maximum smile, especially in subjects with high smile lines. CONCLUSION: This study shows that the nasolabial compartment is a single unit and any change in 1 part may influence the other parts. Further studies should be conducted to investigate these interactions.

Correction of lower facial wideness due to masseter hypertrophy.

Masseter hypertrophy is an uncommon condition that can cause aesthetic and functional problems. Various treatment options were suggested by authors. We used surgical intraoral approaches in 5 patients, which consist of masseter muscle reduction and monocortical ostectomy in the angle of the mandible. Results showed good aesthetic results without any complication. We suggest the use of surgical treatment to gain optimal aesthetic results especially in a square face.