The impact of glucagon-like peptide-1 receptor agonists in the patients undergoing anesthesia or sedation: systematic review and meta-analysis.

BACKGROUND: Glucagon-like peptide-1 agonist receptors (GLP-1RAs), medications used for glycemic control and weight loss, are increasing worldwide. In the perioperative period, the major concern related to GLP-1RA is gastric emptying delay and risk of aspiration. This meta-analysis and systematic review compared the risks and benefits of using GLP-1 agonist receptors and control in surgical and nonsurgical procedures under anesthesia or sedation. METHODS: We systematically searched MEDLINE, Embase, and Cochrane for randomized controlled trials and observational studies involving patients > 18 years undergoing elective surgeries or procedures. Outcomes of interest were pre-procedural gastrointestinal (GI) symptoms, residual gastric content assessed by endoscopy, pulmonary aspiration during anesthesia/sedation, perioperative glycemic control, postoperative inotropic support, nausea/vomiting (PONV), atrial fibrillation, and 30-day mortality rate. We used a random effects model, with odds ratio and mean difference computed for binary and continuous outcomes, respectively. RESULTS: Fourteen randomized and observational studies with 2143 adult patients undergoing elective surgeries and procedures were included. GLP-1RA resulted in increased pre-procedural GI symptoms (OR 7.66; 95% CI 3.42, 17.17; p < 0.00001; I2 = 0%) and elevated residual gastric content (OR 6.08; 95% CI 2.86, 12.94; p < 0.00001; I2 = 0%). GLP-1RA resulted in lower glycemic levels (MD - 0.73; 95% CI - 1.13, - 0.33; p = 0.0003; I2 = 90%) and lower rate of rescue insulin administration (OR 0.39; 95% CI 0.23, 0.68 p = 0.0009; I2 = 35%). There was no significant difference in rate of perioperative hypoglycemia (OR 0.60; 95% CI 0.29, 1.24; p = 0.17; I2 = 0%), hyperglycemia (OR 0.89; 95% CI 0.59, 1.34; p = 0.58; I2 = 38%), need for postoperative inotropic support (OR 0.57; 95% CI 0.33, 1.01; p = 0.05; I2 = 0%), atrial fibrillation (OR 1.02; 95% CI 0.52, 2.01; p = 0.95; I2 = 16%), rate of PONV (OR 1.35; 95% CI 0.82, 2.21; p = 0.24; I2 = 0%), and 30-day mortality rate (OR 0.54; 95% CI 0.14, 2.05; p = 0.25; I2 = 0%). CONCLUSION: Compared to control, pre-procedural GLP-1RA increased the rate of GI symptoms and the risk of elevated residual gastric content despite adherence to fasting guidelines. GLP-1RA improved glycemic control and decreased the rate of rescue insulin administration. There was no significant difference in the rates of perioperative hypo or hyperglycemia, postoperative inotropic support, PONV, atrial fibrillation, and 30-day mortality.

Genotype-by-gestational thermal environment interaction and its impact on the future performance of tropical composite beef cattle offspring.

With global warming, there are growing challenges for raising taurine and composite beef cattle populations in tropical regions, including elevated temperatures, limited forage availability, parasite infestation, and infectious diseases. These environmental factors can trigger specific physiological responses in the developing fetus, which may have long-term implications on its performance. Therefore, the main objective of this study was to assess the influence of naturally-induced thermal stress during the gestation period on the subsequent performance of tropical composite beef cattle progeny. Furthermore, we aimed to investigate the impact of genotype-by-gestational thermal environment interaction (G×Eg) on traits under selection pressure in the breeding population. A total of 157,414 animals from 58 farms located in various Brazilian states were recorded for birth weight (BW), pre-weaning weight gain (PWG), yearling weight (YW), hip height (HH), scrotal circumference (SC), and days to first calving (DFC). We first applied a linear regression model to the BW data, which revealed that the last 40 days of gestation were suitable for calculating the mean temperature humidity index (THIg). Subsequent regression analyses revealed that for every 10-unit increase in THIg, detrimental effects of approximately 1.13% to 16.34% are expected for all traits evaluated. Genetic parameters were estimated through a reaction norm model using THIg as the environmental descriptor. The posterior means of heritability estimates (standard deviation) were 0.35 (0.07), 0.25 (0.03), 0.31 (0.03), 0.37 (0.01), 0.29 (0.07), and 0.20 (0.09) for the direct effect of BW, PWG, YW, HH, SC, and DFC, respectively. These estimates varied along the range of THIg values, suggesting a variable response to selection depending on the thermal environment during gestation. Genetic correlation estimates between more divergent THIg values were low or negative for YW, PWG, and DFC, indicating that the best-performing individuals at low THIg values may not perform as well at high THIg values and vice versa. Overall, thermal stress during gestation impacts the future performance of beef cattle offspring. Our results indicate the need for developing effective breeding strategies that take into account G×Eg effects and the re-ranking of breeding animals along the THIg scale, particularly for traits such as DFC that are highly sensitive to thermal stress.

Transgenerational effects of the maternal gestational environment on the post-natal performance of beef cattle: A reaction norm approach.

In tropical beef cattle production systems, animals are commonly raised on pastures, exposing them to potential stressors. The end of gestation typically overlaps with a dry period characterized by limited food availability. Late gestation is pivotal for fetal development, making it an ideal scenario for inter- and transgenerational effects of the maternal gestational environment. Intergenerational effects occur due to exposure during gestation, impacting the development of the embryo and its future germline. Transgenerational effects, however, extend beyond direct exposure to the subsequent generations. The objective of the present study was to verify these effects on the post-natal performance of zebu beef cattle. We extended the use of a reaction norm model to identify genetic variation in the animals' responses to transgenerational effects. The inter- and transgenerational effects were predominantly positive (-0.09% to 19.74%) for growth and reproductive traits, indicating improved animal performance on the phenotypic scale in more favourable maternal gestational environments. Additionally, these effects were more pronounced in the reproductive performance of females. On average, the ratio of direct additive genetic variances of the slope and intercept of the reaction norm ranged from 1.23% to 3.60% for direct and from 10.17% to 11.42% for maternal effects. Despite its relatively modest magnitude, this variation proved sufficient to prompt modifications in parameter estimates. The average percentage variation of direct heritability estimates ranged from 19.3% for scrotal circumference to 33.2% for yearling weight across the environmental descriptors evaluated. Genetic correlations between distant environments for the studied traits were generally high for direct effects and far from unity for maternal effects. Changes in EBV rankings of sires across different gestational environments were also observed. Due to the multifaceted nature of inter- and transgenerational effects of the maternal gestational environment on various traits of beef cattle raised under tropical pasture conditions, they should not be overlooked by producers and breeders. There were differences in the specific response of beef cattle to variations in the quality of the maternal gestational environment, which can be partially explained by transgenerational epigenetic inheritance. Adopting a reaction norm model to capture a portion of the additive variance induced by inter- or transgenerational effects could be an alternative for future research and animal genetic evaluations.

Pandemics, intellectual property and 'our economy': A worldview analysis of Canada's role in compromising global access to COVID-19 vaccines.

Despite self-congratulatory rhetoric, Canada compromised COVID-19 vaccine equity with policies impeding a proposed global waiver of vaccine intellectual property (IP) rules. To learn from Canada's vaccine nationalism we explore the worldview - a coherent textual picture of the world - in a sample of Government of Canada communications regarding global COVID-19 vaccine sharing. Analysed documents portray risks and disparities as unrelated to the dynamics and power relations of the Canadian and international economies. Against this depoliticised backdrop, economic growth fueled by strict IP rules and free trade is advanced as the solution to inequities. Global vaccine access and distribution are pursued via a charity-focused public-private-partnership approach, with proposals to relax international IP rules dismissed as unhelpful. Rather than a puzzling lapse by a good faith 'middle power', Canada's obstruction of global COVID-19 vaccine equity is a logical and deliberate extension of dominant neoliberal economic policy models. Health sector challenges to such models must prioritise equity in global pandemic governance via politically assertive and less conciliatory stances towards national governments and multilateral organisations. Mobilisation for health equity should transform the overall health-damaging macroeconomic model, complementing efforts based on specific individual health determinants or medical technologies.

Genetic parameters, genetic trends and correlated responses of growth traits considering maternal ability in Nelore cattle.

The growth of Nelore cattle was analysed considering the following performance parameters; the effect of the calving order of cows on the phenotypic expression of birth weight (BW), average daily gain from birth to weaning (BWG), and weaning weight (WW), the estimated genetic parameters for the traits, including the covariance components between direct and maternal genetic effects. Genetic trends and correlated responses were also obtained for the studied traits. The calving order of cows, as well as other fixed effects used to obtain the adjusted phenotypic means, were statistically significant (p < 0.001) for studied traits. Direct heritability was estimated at 0.24 ± 0.01 (BW), 0.15 ± 0.01 (BWG), and 0.18 ± 0.01 (WW), while maternal heritability was 0.06 ± 0.01 (BW), 0.12 ± 0.01 (BWG), and 0.11 ± 0.01 (WW). The correlations between direct and maternal effects within the same trait were negligible. Moderate to higher direct genetic correlations (ranging from 0.54 ± 0.04 to 0.98 ± 0.01) and maternal genetic correlations (ranging from 0.34 ± 0.09 to 0.99 ± 0.002) were estimated between the studied traits. Unlike direct genetic effects, there was no significant change in maternal genetic effects over time (p > 0.05). These results indicated the need for revising selection indexes for enhancing maternal ability. Correlated responses were generally lower compared to direct responses, except for BWG. The selection for BWG, considering the maternal genetic effect, would be more efficient to improve maternal ability of the cows for pre-weaning growth in relation to selection for WW. Our results found that direct genetic merit improves pre-weaning weight and this trait can be incorporated into the breeding goal as reflected in the WW.

Antimicrobial and optical properties of a new biogenic silica-coated silver nanoparticles incorporated into experimental resin.

Background: Evaluate the effects of incorporating silica-coated silver nanoparticles (Ag@SiO2 NPs) into odontological clinic resin materials. Material and Methods: Silver nanoparticles coated with silicon dioxide were added to the experimental resin matrix at 1, 3, and 5wt%. Degree of conversion (DC), optical properties (total transmittance and color change), and microstructural analysis were evaluated. Materials were tested for silver ion release, cytotoxicity in dental pulp fibroblasts, Streptococcus mutans biofilm growth by Colony-Forming Unit (CFU) and confocal laser scanning microscopy (CLSM). Results: Groups had a similar DC, despite significant differences observed in transmittance and color change analysis for all groups with NPs. Silver ion release values were below the detection limit after 72h for all groups, and NPs incorporation did not show a statistical difference from the control on pulp fibroblasts assay. After 72h, the CFU count was significantly reduced by 74% from 3wt% of Ag@SiO2NPs. CLSM evaluation on S. mutans colonies showed a dose-dependent decrease in the emitted fluorescence. Conclusions: The application of Ag@SiO2 NPs in a resinous matrix, demonstrates a significant reduction of S. mutans CFU in oral biofilm, at concentrations from 3wt%, without an increase in cytotoxicity. The reduced transmittance values did not affect the DC, although a significant color change was perceived in all concentrations. Key words:Nanoparticles, Silver Compounds, Composite Dental Resin, Anti-Bacterial Agent, Optical Imaging.

An automated method to analyze root filling voids and gaps using confocal microscopy images.

This study evaluated the feasibility of an automated method to delimit the required area to quantitatively analyze root filling voids and gaps from cross-sectional confocal laser scanning microscopy (CLSM) images. Root canals of maxillary canines were prepared with rotary instruments and filled by lateral compaction technique using gutta-percha and AH Plus sealer. The roots were stored (100% humidity, 37 °C) for a period of 24 h and then transversally sectioned to obtain 2-mm-thick slices from the apical and middle thirds. The areas corresponding to filling materials, gaps, and voids were manually delimited or automatically demarked by ImageJ software after converting the images to the RGB color system. Based on manual and automatic delimitations, the percentages of voids and gaps were calculated. Data of voids and gaps between middle and apical thirds were individually compared by paired t-test. Pearson`s correlation test was used to assess the correlation of data between the methods. Irrespective of the method of area delimitation, no difference was observed between the root thirds for both voids and gaps, while the p-values calculated for each method were similar. Almost perfect correlations between the methods were observed for both outcomes. The proposed method to automatically delimit the areas corresponding to filling material, voids, and gaps appears to be a valid method to facilitate the quantitative analysis of defects in root canal fillings using topographic CSLM images.

New-onset delirium during hospitalization in older adults: incidence and risk factors.

OBJECTIVE: Delirium is a clinical diagnosis that can occur frequently in hospitalized patients. A retrospective study was completed to identify the incidence of patients aged greater than 65 developing delirium during hospitalization. METHODS: This study was conducted at a single tertiary care teaching hospital. Charts of discharged patients from November to December 2018 were evaluated and patients less than age 65 or with delirium present on admission were excluded. The search terms altered, delirium, encephalopathy, and confusion were used to identify patients who developed delirium during the hospitalization. Characteristics of the patients with delirium were also collected. RESULTS: The incidence of new-onset delirium in patients over age 65 during hospitalization was 10%. Patients who developed delirium during their hospital stay were found to have a higher risk of mortality (p = 0.0028) and severity of illness (p = 0.014). A strong correlation between the length of stay (LOS) and incidence of delirium was also noted. CONCLUSION: The strong correlation between a longer LOS and a higher incidence of delirium should guide the development of new innovative strategies to shorten the LOS and thus reduce the risk of delirium, in high-risk older hospitalized patients.

Incidental Diagnosis of Rheumatic Myocarditis during Cardiac Surgery-Impact on Late Prognosis.

Rheumatic fever (RF) and rheumatic heart disease (RHD) are still highly prevalent, particularly in low- and middle-income countries. RHD is a neglected and underdiagnosed disease for which no specific laboratory diagnostic test is completely reliable. This is a retrospective observational study, which included 118 patients with RHD who underwent cardiac surgery from 1985 to 2018. The aim of this investigation was to evaluate the clinical, epidemiological, echocardiographic and pathological characteristics in two cohorts of RHD patients: one cohort with Aschoff bodies present in their pathological results and the other without such histopathological characteristics. No conventional clinical and laboratory tests for RHD myocarditis were able to identify active carditis during the preoperative phase of valve repair or replacement. Patients who had Aschoff bodies in their pathological results were younger (median age of 13 years (11-24 years) vs. 27 years (17-37 years), p = 0.001) and had higher rate of late mortality (22.9% vs. 5.4%, p = 0.043). In conclusion, the presence of Aschoff bodies in pathological findings may predict increased long-term mortality, emphasizing the importance of comprehensive pathology analysis for suspected myocarditis during heart surgery.

Effects of monensin in supplements for beef cattle in tropical grazing systems during the rainy season.

Two experiments were carried out to evaluate the effect of monensin in supplements for grazing heifers. In experiment I, treatments consisted of protein supplements (low intake - 0.5 kg/animal/day and high intake - 1.0 kg/animal/day) associated or not with monensin. Animal performance, nutrient intake, and digestibility were evaluated. Forty crossbred heifers with an initial body weight (BW) of 213.8 ± 4.5 kg were used. There was no difference in average daily gain between treatments (average of 0.588 kg/animal/day). There was no interaction between monensin and supplements for intake parameters and digestibility. Dry matter (DM) intake was equal between treatments (~ 2% of BW). However, there was a reduction in pasture intake with the high-intake supplement. In experiment II, treatments consisted of two types of supplements (protein or mineral) associated or not with monensin. The variables analyzed were productive performance, ingestive behavior, and thermal comfort, evaluated through the index of thermal stress for cows (ITSC). Forty crossbred heifers with a BW of 159.2 ± 1.3 kg were used. The type of supplement did not influence the performance of the animals. However, monensin promoted greater weight gain in the animals (110 g/animal/day). There was an interaction effect between supplementation and monensin addition on behavioral activities, except for idle time. The inclusion of monensin in the protein supplement reduced the grazing time. The ITSC value influenced the activities of ingestive behavior, and the increase of this index reduced the grazing time in all treatments. Forage quality influences the response to monensin use, and the addition of monensin in supplements for grazing cattle during the rainy season is recommended for forages with high CP content.

The Quality Improvement Fellow: Educating on Making the Difference.

The critical care medicine (CCM) fellowship is an opportunity for advanced anesthesiology trainees to refine their quality improvement (QI) skills. However, the short training period and inconsistent curricula make this challenging. The QI fellow (QIF) is described as an education program to provide consistent QI training during the CCM fellowship. The QIF is a mentored position to help manage data review, QI conferences, and improvement efforts within the CCM Division. The curriculum is focused on a QI education framework and mentored experiential learning. The QIF program is an opportunity for education and mentorship in the role of a CCM operational leader.

Fipronil Degradation in Soil by Enterobacter chengduensis Strain G2.8: Metabolic Perspective.

Fipronil is an insecticide widely used in the agricultural and veterinary sectors for its efficacy in pest control. The presence of fipronil in the environment is mainly due to agricultural and domestic practices and is frequently found in different types of environmental matrices in concentrations ranging from µg/L to mg/L and can be hazardous to non-target organisms due to its high toxicity. This study was carried out to obtain and characterize microorganisms from soil which are capable of biodegrading fipronil that could be of great biotechnological interest. For this purpose, bioprospecting was carried out using fipronil (0.6 g/L) as the main source of carbon and nitrogen for growth. Once obtained, the strain was identified by sequencing the 16S ribosomal RNA (rRNA) gene and the capacity to degrade fipronil was monitored by GC-MS. Our study showed a presence in soil samples of the strain identified as Enterobacter chengduensis, which was able to metabolize fipronil and its metabolites during the mineralization process. Enterobacter chengduensis was able to biodegrade fipronil (96%) and its metabolites fipronil-sulfone (92%) and fipronil-sulfide (79%) in 14 days. Overall, the results of this study provided a bacterium with great potential that could contribute to the degradation of fipronil in the environment.

The Interplay of Raloxifene and Sonochemical Bio-Oss in Early Maxillary Sinus Bone Regeneration: A Histological and Immunohistochemical Analysis in Rabbits.

The study aimed to assess the efficacy of using Raloxifene with ultrasonic processing to enhance Bio-Oss®, a bone graft substitute, for maxillary sinus bone height reconstruction. A total of 24 rabbit maxillary sinuses were distributed into three groups, each receiving different treatments: Bio-Oss® only, sonicated Bio-Oss, and sonicated Bio-Oss® with Raloxifene. Surgical procedures and subsequent histomorphometric and immunohistochemistry analyses were conducted to evaluate the bone formation, connective tissue, and remaining biomaterial, as well as the osteoblastic differentiation and maturation of collagen fibers. Results indicated that the sonicated Bio-Oss® and Bio-Oss® groups showed similar histological behavior and bone formation, but the Raloxifene group displayed inflammatory infiltrate, low bone formation, and disorganized connective tissue. The statistical analysis confirmed significant differences between the groups in terms of bone formation, connective tissue, and remaining biomaterial. In conclusion, the study found that while sonicated Bio-Oss® performed comparably to Bio-Oss® alone, the addition of Raloxifene led to an unexpected delay in bone repair. The findings stress the importance of histological evaluation for accurate bone repair assessment and the necessity for further investigation into the local application of Raloxifene. Future research may focus on optimizing bone substitutes with growth factors to improve bone repair.

Genotype by Prenatal Environment Interaction for Postnatal Growth of Nelore Beef Cattle Raised under Tropical Grazing Conditions.

The prenatal environment is recognized as crucial for the postnatal performance in cattle. In tropical regions, pregnant beef cows commonly experience nutritional restriction during the second half of the gestation period. Thus, the present study was designed to analyze the genotype by prenatal environment interaction (G × Epn) and to identify genomic regions associated with the level and response in growth and reproduction-related traits of beef cattle to changes in the prenatal environment. A reaction norm model was applied to data from two Nelore herds using the solutions of contemporary groups for birth weight as a descriptor variable of the gestational environment quality. A better gestational environment favored weights until weaning, scrotal circumference at yearling, and days to first calving of the offspring. The G × Epn was strong enough to result in heterogeneity of variance components and genetic parameters in addition to reranking of estimated breeding values and SNPs effects. Several genomic regions associated with the level of performance and specific responses of the animals to variations in the gestational environment were revealed, which harbor QTLs and can be exploited for selection purposes. Therefore, genetic evaluation models considering G × Epn and special management and nutrition care for pregnant cows are recommended.

Finite element analysis of low-profile reconstruction plates for atrophic mandibles: a comparison of novel 3D grid and conventional plate designs.

OBJECTIVES: This study aimed to compare the reconstruction with type 2.4 and three-dimensional (3D) grid plates relating the areas of weakness to anatomical regions of force incidence in atrophic mandibles with and without segmentation using finite element analysis (FEA). MATERIALS AND METHODS: Strength and force quality in the mandible were also determined. The atrophic mandible models with and without segmentation were divided into four groups, and the behavior of each plate was analyzed using finite element analysis. In the atrophic mandible without segmentation using the type 2.4 reconstruction plate, the highest stress concentration in the plate was observed in the posterior region of the mandibular body and in the grid type 3D reconstruction plate was observed in the mandibular angle. RESULTS: In the segmented atrophic mandible with the 2.4 reconstruction plate, higher stress concentration was observed in the mandibular segment defect. Analysis of the 3D grid-like reconstruction plate revealed that the geometry of the plate conferred greater stiffness to the assembly, as the most significant stress concentration was observed at the mandibular angle. CONCLUSION: The width of the plate design may influence the strength, not the thickness.

Subchronic exposure to 1,2-naphthoquinone induces adipose tissue inflammation and changes the energy homeostasis of mice, partially due to TNFR1 and TLR4.

Air pollution affects energy homeostasis detrimentally. Yet, knowledge of how each isolated pollutant can impact energy metabolism remains incomplete. The present study was designed to investigate the distinct effects of 1,2-naphthoquinone (1,2-NQ) on energy metabolism since this pollutant increases at the same rate as diesel combustion. In particular, we aimed to determine in vivo effects of subchronic exposure to 1,2-NQ on metabolic and inflammatory parameters of wild-type mice (WT) and to explore the involvement of tumor necrosis factor receptor 1 (TNFR1) and toll-like receptor 4 (TLR4) in this process. Males WT, TNFR1KO, and TLR4KO mice at eight weeks of age received 1,2-NQ or vehicle via nebulization five days a week for 17 weeks. In WT mice, 1,2-NQ slightly decreased the body mass compared to vehicle-WT. This effect was likely due to a mild food intake reduction and increased energy expenditure (EE) observed after six weeks of exposure. After nine weeks of exposure, we observed higher fasting blood glucose and impaired glucose tolerance, whereas insulin sensitivity was slightly improved compared to vehicle-WT. After 17 weeks of 1,2-NQ exposure, WT mice displayed an increased percentage of M1 and a decreased (p = 0.057) percentage of M2 macrophages in adipose tissue. The deletion of TNFR1 and TLR4 abolished most of the metabolic impacts caused by 1,2-NQ exposure, except for the EE and insulin sensitivity, which remained high in these mice under 1,2-NQ exposure. Our study demonstrates for the first time that subchronic exposure to 1,2-NQ affects energy metabolism in vivo. Although 1,2-NQ increased EE and slightly reduced feeding and body mass, the WT mice displayed higher inflammation in adipose tissue and impaired fasting blood glucose and glucose tolerance. Thus, in vivo subchronic exposure to 1,2-NQ is harmful, and TNFR1 and TLR4 are partially involved in these outcomes.

Conventional and Digital Impressions for Fabrication of Complete Implant-Supported Bars: A Comparative In Vitro Study.

Obtaining accurate models and well-fitting prostheses during the fabrication of complete implant-supported prostheses has been a significant challenge. Conventional impression methods involve multiple clinical and laboratory steps that can lead to distortions, potentially resulting in inaccurate prostheses. In contrast, digital impressions may eliminate some of these steps, leading to better-fitting prostheses. Therefore, it is important to compare conventional and digital impressions for producing implant-supported prostheses. This study aimed to compare the quality of digital intraoral and conventional impressions by measuring the vertical misfit of implant-supported complete bars obtained using both types of techniques. Five digital impressions using an intraoral scanner and five impressions using elastomer were made in a four-implant master model. The plaster models produced with conventional impressions were scanned in a laboratory scanner to obtain virtual models. Screw-retained bars (n = five) were designed on the models and milled in zirconia. The bars fabricated using digital (DI) and conventional (CI) impressions were screwed to the master model, initially with one screw (DI1 and CI1) and later with four screws (DI4 and CI4), and were analyzed under a SEM to measure the misfit. ANOVA was used to compare the results (p < 0.05). There were no statistically significant differences in the misfit between the bars fabricated using digital and conventional impressions when screwed with one (DI1 = 94.45 µm vs. CI1 = 101.90 µm: F = 0.096; p = 0.761) or four screws (DI4 = 59.43 µm vs. CI4 = 75.62 µm: F = 2.655; p = 0.139). Further, there were no differences when the bars were compared within the same group screwed with one or four screws (DI1 = 94.45 µm vs. DI4 = 59.43 µm: F = 2.926; p = 0.123; CI1 = 101.90 µm vs. CI4 = 75.62 µm: F = 0.013; p = 0.907). It was concluded that both impression techniques produced bars with a satisfactory fit, regardless of whether they were screwed with one or four screws.

Influence of image file and white balance on photographic color assessment.

STATEMENT OF PROBLEM: How the color parameters obtained from digital photographs may be influenced by illumination, file format, and subject color is unclear. PURPOSE: The purpose of this in vitro study was to evaluate color differences (ΔE00) and CIELab color coordinates among different types of file formats of dental shade tab images with and without white balance. MATERIAL AND METHODS: Different shade tab colors (n=10) were photographed with a digital camera under standard conditions. The photographs were stored in RAW, JPEG, and TIFF file formats and evaluated with and without white balance (WB) adjustment by using an image software program and a gray reference card with known color coordinates. CIEDE2000 color differences between each image file format and the control group (RAW WB) were calculated, and interpreted by the visual perceptibility (PT00=0.8) and acceptability (AT00=1.8) thresholds. The ΔE00 color shift was defined according to CIEDE2000 lightness, chroma, and hue and interpreted by the following respective visual acceptability thresholds: 2.92, 2.52, and 1.90. The differences among the color coordinates were analyzed by Kruskal-Wallis and Bonferroni post hoc tests (α=.05). RESULTS: The color coordinates presented statistically significant differences between the file formats and control group (P<.001). Excellent matches (ΔE00 ≤0.8) were observed on TIFF and JPEG saved from RAW-WB. Images without WB presented unacceptable mismatches (ΔE00 >5.4). ΔE00 color shift of images without WB were predominantly influenced by ΔH00, while JPEG, WB, and TIFF WB were mostly influenced by ΔC00. CONCLUSIONS: Only compressed JPEG or TIFF files of dental shade tabs derived from original RAW WB photographs were able to achieve color differences within the limits of the 50:50% perceptibility threshold, providing excellent color matches with the RAW WB files.

Harnessing the Power of PAOO and Invisalign: An Interdisciplinary Approach to Orthodontic Care.

The present article explores the benefits of combining periodontally accelerated osteogenic orthodontics (PAOO) with Invisalign for optimal orthodontic treatment outcomes. PAOO is an interdisciplinary dental technique that minimizes complications and accelerates tooth movement while enhancing various orthodontic treatments. In conjunction with Invisalign, PAOO provides a discreet and comfortable solution for patients seeking to improve their smile. The study presents two challenging cases successfully treated using this combined approach, emphasizing the technique's potential to reduce treatment times and improve orthodontic outcomes. The interdisciplinary approach of PAOO ensures long-term success and stability by preserving periodontal structures and addressing potential bony defects. By incorporating bone grafting materials, PAOO helps prevent common concerns in traditional orthodontic treatments, such as bony defects and gingival recession. Furthermore, the combination with Invisalign offers a more aesthetically pleasing and comfortable treatment experience, allowing patients to maintain their self-esteem and confidence throughout the treatment. Despite the potential advantages, dental professionals must manage patient expectations and address potential complications to ensure the best possible results. Overall, the integration of PAOO and Invisalign demonstrates a viable alternative for patients who do not want to proceed with orthognathic surgery, enhancing patient satisfaction and overall treatment outcomes.