Posterior thoracic antedisplacement and fusion surgery for a special type of ossification of the posterior longitudinal ligament in the thoracic spine: indications and preliminary clinical results of 2-year follow-up.

OBJECTIVES: To describe a novel technique, posterior thoracic antedisplacement and fusion (PTAF), for a special type of ossification of the posterior longitudinal ligament in the thoracic spine (T-OPLL), and to evaluate its safety and efficacy. METHODS: From July to December 2020, five consecutive patients with beak-type T-OPLL located at the thoracic vertebral body (VB) level underwent PTAF surgery. Their demographic data, radiological parameters, perioperative complications, and surgery-related findings were recorded and analyzed. The surgical outcomes were assessed using a modified Japanese Orthopedic Association (mJOA) scale, and the recovery rate (RR) was calculated using the Hirabayashi's method. RESULTS: All patients were followed up for at least two years. The mean thickness of OPLL was 9.4 ± 1.0 mm, and the OPLL spinal canal occupying ratio was 67.7% ± 8.5%. Postoperatively, the mean antedisplacement distance of OPLL was 8.1 ± 1.8 mm, and the average shortened distance of the spinal column was 6.0 ± 1.13 mm. The mean operation time and blood loss were 158.2 ± 26.3 min and 460 ± 89.4 mL, respectively. Perioperative complications were cerebrospinal fluid leakage and instrument failure, 2 cases each. The mean mJOA score was increased from 3.6 ± 2.9 before surgery to 9.4 ± 3.0 at the last follow-up, and the average RR was 84.2 ± 30.5%. CONCLUSION: The preliminary clinical outcomes indicate that PTAF is a safe and effective method for the treatment of beak-type T-OPLL, which has its apex located at the VB level and has a high spinal canal occupation ratio.

Application of the Knife-Edge Technique on Transition Metal Dichalcogenide Monolayers for Resolution Assessment of Nonlinear Microscopy Modalities.

We report application of the knife-edge technique at the sharp edges of WS2 and MoS2 monolayer flakes for lateral and axial resolution assessment in all three modalities of nonlinear laser scanning microscopy: two-photon excited fluorescence (TPEF), second- and third-harmonic generation (SHG, THG) imaging. This technique provides a high signal-to-noise ratio, no photobleaching effect and shows good agreement with standard resolution measurement techniques. Furthermore, we assessed both the lateral resolution in TPEF imaging modality and the axial resolution in SHG and THG imaging modality directly via the full-width at half maximum parameter of the corresponding Gaussian distribution. We comprehensively analyzed the factors influencing the resolution, such as the numerical aperture, the excitation wavelength and the refractive index of the embedding medium for the different imaging modalities. Glycerin was identified as the optimal embedding medium for achieving resolutions closest to the theoretical limit. The proposed use of WS2 and MoS2 monolayer flakes emerged as promising tools for characterization of nonlinear imaging systems.

Use of Caudal Quadratus Lumborum Block with Ropivacaine as Part of an Opioid-Free Analgesic Protocol in Dogs Undergoing Orchiectomy: A Randomized Trial.

In veterinary medicine, the use of loco-regional anesthesia techniques is increasing. The Quadratus Lumborum block (QL) is an interfascial loco-regional technique that involves the release of local anesthetic (LA) between the Quadratus Lumborum and the Small Psoas (Pm) muscle. The study aims to evaluate the effect of the QL block on reducing the total amount of opioids in dogs undergoing pre-scrotal orchiectomy. A group of 36 dogs was enrolled in a randomized blinded study. The animals were divided into two groups: 18 in the experimental group (QL) and 18 in the control group (C). The QL group received 0.4 mL kg-1 of ropivacaine 0.5% for each hemiabdomen (total amount of 3 mg kg-1 of ropivacaine, 1.5 mg kg-1 per side). The C group was brought into the operating room (OR) after receiving the same clipping as the QL group. In the intraoperative period, opioid consumption in the QL group was significantly lower than in the C group. No differences were found in the post-operative phase. No side effects were reported when performing the QL technique. The QL block performed at the level of L6 appears to be a valid approach to reducing opioid use in dogs undergoing orchidectomy with a pre-scrotal surgical approach.

Shear Bond Strength of Orthodontic Brackets Bonded with Thermo-Cured Glass-Based Materials-An In Vitro Study.

The results of orthodontic therapy largely depend, among other factors, on the preparation of the tooth enamel itself and the choice of material used to bond orthodontic brackets. The aim of this in vitro study was to determine the shear bond strength (SBS) and adhesive remnant index (ARI) score of thermo-cured glass-ionomers on different pretreated enamel, in comparison with the commonly used composite cement. Three commercially available nano-ionomer or highly viscous glass-ionomer cements (EQUIA Forte® Fil, EQUIA Fil, Ketac Universal) and two types of compo-sites (Heliosit Orthodontic, ConTec Go!) were investigated in this study. The research involved two hundred human premolars. The teeth were cleaned and polished, then randomly divided into five groups according to the enamel preparation method and the type of material. The enamel was treated in three different ways: polyacrylic acid, phosphoric acid, 5% NaOCl + etching with phosphoric acid, and a control group without treatment. Glass-ionomer cement was thermo-cured with heat from a polymerization unit during setting. Statistical analysis was performed using a Chi-square test and one-way ANOVA for independent samples. Spearman's Rho correlation coefficient was used to examine the relationship. Regardless of the material type, the results indicated that the weakest bond between the bracket and tooth enamel was found in samples without enamel pretreatment. The majority of the materials stayed on the brackets in samples without enamel preparation, according to ARI scores. The study's findings demonstrated that the strength of the adhesion between the bracket and enamel is greatly influenced by enamel etching and glass-ionomer thermo-curing. Clinical investigations would be required to validate the outcomes.

Effect of male parental gamma irradiation on host suitability of its F1 progeny of a lepidopteran tropical pest, Spodoptera litura (Fabr.) towards development and virulence of entomopathogenic nematodes, Steinernema thermophilum.

The suitability of F1 progeny insect larvae of the irradiated male parent, Spodoptera litura (Fabr.) for infective juveniles (IJs) of entomopathogenic nematodes (EPN), Steinernema thermophilum was assessed to comprehend the feasibility of combining EPNs with nuclear pest control tactic. As compared to the control, the IJs induced faster host mortality with reduced proliferation in F1 host larvae. IJs derived from F1 host larvae exhibited almost similar proliferation capacity on normal hosts as in control. Further, the molecular basis of EPNs induced mortality in F1 host larvae was evaluated. Dual stress of EPN infection and irradiation induced downregulation of the relative mRNA expression of antimicrobial genes and upregulated expression of antioxidative genes. A pronounced effect of EPNs in association with irradiation stress was apparent on host mortality. Radiation induced sterile F1 insect larvae of S. litura acted as a reasonably suitable host for EPNs and also provided the environment for developing viable EPNs for their potential use as biocontrol agents.

Diagnostic value of high-resolution vessel wall imaging technique in intracranial arterial stenosis and occlusion: a comparative analysis with digital subtraction angiography.

OBJECTIVE: To analyze the diagnostic value of HR-VWI in intracranial arterial stenosis and occlusion and compare it with DSA. METHODS: A retrospective analysis of clinical data of 59 patients with intracranial arterial stenosis in our hospital was conducted to compare the diagnostic results of the two methods for different degrees of intracranial stenosis and various morphological plaques. RESULTS: The diagnosis of stenosis and occlusion by both methods showed no significant difference (p > 0.05). Comparison of plaque morphology detected by HR-VWI with pathological examination results showed no significant difference (p > 0.05); however, there was a significant difference between plaque morphology detected by DSA and pathological examination results (p < 0.05). Additionally, there was a significant difference between plaque morphology detected by HR-VWI and DSA (p < 0.05). CONCLUSION: HR-VWI technique is comparable to DSA technique in diagnosing intracranial arterial stenosis and occlusion, but it is superior to DSA in plaque morphology diagnosis.

Ultrasound-guided joint procedures in hemophilia: technique, indications and tips.

INTRODUCTION: The therapeutic approach to pain in hemophilia should be multimodal. Intra-articular injections are a good option when joint lesions do not respond to hematological treatment or rehabilitation and orthopedic surgery is not yet indicated. Performing these procedures under ultrasound guidance has been shown to improve their accuracy and efficacy. AREAS COVERED: This article provides a practical overview of the most frequently employed ultrasound-guided intra-articular procedures on the joints of people with hemophilia. The article describes the key elements for performing the technique on the elbow, knee and ankle as the most affected joints. The particularities of the most frequent indications, arthrocentesis, synoviorthesis and analgesic injections with various products are detailed. EXPERT OPINION: Current hematological treatments have made it possible to incorporate new therapeutic tools for pain relief for people with hemophilia, including ultrasound-guided joint injections, which offer excellent results.

Assessment of masticatory performance in pediatric patients receiving preformed crowns by Hall technique: a controlled clinical trial.

PURPOSE: The purpose of the study was to assess and compare the masticatory performance in children receiving preformed metal crown by Hall technique and conventional technique. METHODS: Children having teeth indicated for restorative/endodontic therapy and belonging to the age group of six to ten years were invited to participate in the study. Eighteen children received preformed metal crowns (PMCs) by Hall technique. Meanwhile, nineteen children received preformed metal crowns by the conventional technique. Their masticatory performance (MP) was assessed at T0 (pre-intervention), T1 (day 1 post-intervention), T2 (1 week), T3 (2 weeks), T4 (1 month) and T5 (3 months) using Hue-check Gum® (University of Bern, Switzerland). The chewing gum samples were scanned within 24 h of their collection and processed in the ViewGum Software©. The software calculated the hue value (VOH) which indicated the masticatory performance of the individual. A questionnaire was given to the parents at T4 and T5 to assess any discomfort or pain associated with PMCs placed in both groups. RESULTS: The evaluation of masticatory performance using the two-color chewing method revealed reduction in MP on day 1 post-intervention (p < 0.001) for both groups. However, the MP values recorded at T5 were comparable to the baseline values at T0 (p = 0.009). No significant discomfort or pain was reported in both groups. CONCLUSION: The findings of the current clinical study indicate that placement of PMCs by both conventional and Hall technique in children deteriorates their MP which equilibrates within 1 month. CLINICAL TRIAL REGISTRY OF INDIA NUMBER: CTRI/2021/02/031532 [Registered on: 25/02/2021]-Trial Registered Prospectively.

Optimizing IoT Intrusion Detection Using Balanced Class Distribution, Feature Selection, and Ensemble Machine Learning Techniques.

Internet of Things (IoT) devices are leading to advancements in innovation, efficiency, and sustainability across various industries. However, as the number of connected IoT devices increases, the risk of intrusion becomes a major concern in IoT security. To prevent intrusions, it is crucial to implement intrusion detection systems (IDSs) that can detect and prevent such attacks. IDSs are a critical component of cybersecurity infrastructure. They are designed to detect and respond to malicious activities within a network or system. Traditional IDS methods rely on predefined signatures or rules to identify known threats, but these techniques may struggle to detect novel or sophisticated attacks. The implementation of IDSs with machine learning (ML) and deep learning (DL) techniques has been proposed to improve IDSs' ability to detect attacks. This will enhance overall cybersecurity posture and resilience. However, ML and DL techniques face several issues that may impact the models' performance and effectiveness, such as overfitting and the effects of unimportant features on finding meaningful patterns. To ensure better performance and reliability of machine learning models in IDSs when dealing with new and unseen threats, the models need to be optimized. This can be done by addressing overfitting and implementing feature selection. In this paper, we propose a scheme to optimize IoT intrusion detection by using class balancing and feature selection for preprocessing. We evaluated the experiment on the UNSW-NB15 dataset and the NSL-KD dataset by implementing two different ensemble models: one using a support vector machine (SVM) with bagging and another using long short-term memory (LSTM) with stacking. The results of the performance and the confusion matrix show that the LSTM stacking with analysis of variance (ANOVA) feature selection model is a superior model for classifying network attacks. It has remarkable accuracies of 96.92% and 99.77% and overfitting values of 0.33% and 0.04% on the two datasets, respectively. The model's ROC is also shaped with a sharp bend, with AUC values of 0.9665 and 0.9971 for the UNSW-NB15 dataset and the NSL-KD dataset, respectively.

Establishing consensus on patient- and family-centered care in adult intensive care units: A Delphi survey.

PURPOSE: To establish consensus between intensive care unit (ICU) experts on concrete patient- and family-centered care statements for adult patients and relatives in the ICU. MATERIALS AND METHODS: We did a three-round Delphi survey with a panel of ICU health care professionals from 23 ICUs in Denmark. In round 1, participants answered 20 open-ended questions, based on existing evidence. Analysis of their responses generated close-ended statements, which participants primary rated on a five-point-Likert-scale, from very important to not important at all. In rounds 2 and 3., consensus was predefined as ≥75% of participants rating a statement important. RESULTS: Sixty-nine participated: 38 nurses, 24 physicians, and four occupational and physiotherapists. In total 96%, 90% and 72% answered the first, second, and third rounds, respectively. In round 1, participants answers resulted in >3000 statements that were analyzed into 82 condensed statements. After participants rated the statements in round 2 and 3, 47 statements reached consensus as important. CONCLUSIONS: The 47 statements rated to be important included interdisciplinary approaches to systematic information sharing and consultations with patients and family-members, with the aim being to accommodate patients and family-members´ individual needs throughout the ICU stay.

No-Graft Dural Closure in the Retrosigmoid Approach: Enhancing Outcomes for Neurovascular Conflicts and Beyond.

INTRODUCTION: Achieving watertight dural closure without grafts via the retrosigmoid approach can be challenging, contributing to a significant rate of postoperative cerebrospinal fluid (CSF) leaks. This study describes a dural incision technique for achieving primary dural closure without grafts following the retrosigmoid approach and presents clinical data from the authors' experience. METHODS: Clinical and surgical data of 227 patients who underwent the dural incision technique following the retrosigmoid approach for various pathologies were retrospectively reviewed. To achieve no-graft watertight dural closure, the dural incision involves two critical steps: a 1 cm transverse incision of the dura parallel to the foramen magnum to drain CSF from the cisterna magna, and a vertical linear opening of the retrosigmoid dura. Dural incisions were closed watertight with vicryl 4/0 running sutures, without the use of grafts, fibrin glue, hemostatic overlays, or dural substitutes. Pre- or postoperative lumbar drainage was not employed. RESULTS: Primary watertight dural closure was successfully achieved in all patients without the use of grafts or duraplasty. The average duration of dura closure was 17.7 minutes. During an average follow-up period of 49.3 months, there were no instances of CSF leaks or meningitis. CONCLUSION: In the authors' preliminary experience, the linear dural incision described herein was effetcive for achieving a no-graft, watertight primary dural closure in the retrosigmoid approach, with no CSF leaks or meningitis in our series. Validation of these preliminary data in a larger patient cohort is necessary.

LONG-TERM SURVIVAL AND REINTERVENTION FOLLOWING THORACIC ENDOVASCULAR AORTIC REPAIR IN BLUNT TRAUMATIC THORACIC AORTIC INJURY: A SYSTEMATIC REVIEW AND META-ANALYSIS.

INTRODUCTION: Blunt thoracic aortic injury (BTAI) represents one of the most devastating scenarios of vascular trauma. Different management strategies are available with varying clinical outcomes. However, thoracic endovascular aortic repair (TEVAR) has become the first-line option for most BTAI patients, mainly owing to its minimally invasive nature, yielding improved immediate results. This meta-analysis aims to investigate mortality, long-term survival, and reintervention following TEVAR in BTAI. MATERIAL AND METHODS: A systematic review conducted a comprehensive literature search on multiple electronic databases using strict search terms. Twenty-seven studies met the set inclusion/exclusion criteria. A proportional meta-analysis of extracted data was conducted using the Comprehensive Meta-Analysis Software v.4. RESULTS: 1498 BTAI patients who underwent TEVAR were included. Using the SVS grading system, 2.6% of the population had Grade 1 injuries, 13.6% Grade 2, 62.2% Grade, 19.6% Grade 4, and 1.9% unspecific. All-cause mortality did not exceed 20% in all studies except one outlier with a 37% mortality rate. Using the random-effects model, the pooled estimate of overall mortality was 12% (95%CI 5.35-8.55%; I2 = 70.6%). This was 91% (95%CI, 88.6-93.2; I2 = 30.2%) at 6 months, 90.1% (95%CI, 86.7-92.3; I2 = 53.6%) at 1-year, 89.2% (95%CI, 85.2-91.8; I2= 62.3%) at 2 years, and 88.1% (95%CI, 83.3-90.9; I2 = 69.6%) at 5 years. Moreover, the pooled estimate of reintervention was 6.4% (95%CI, 0.1-0.49%; I2 = 81.7%). CONCLUSION: Despite the high morbidity and mortality associated with BTAI, TEVAR has proven to be a safe and effective management strategy with favourable long-term survival and minimal need for reintervention. Nevertheless, diagnosis of BTAI requires a high index of suspicion with appropriate grading and prompt transfer to trauma centres with appropriate TEVAR facilities.

Spectral and microstructural analysis of the effect of the Ga+implantation on diamond: a CL-EELS study.

Due to its capacity to achieve nanometer-scale machining and lithography, focused ion beam (FIB) is an extended tool for semiconductor device fabrication and development, in particular, for diamond-based devices. However, some technological steps are still not fully optimized for its use. Indeed, ion implantation seems to affect the crystalline structure and electrical properties of diamond. For this study, a boron-doped ([B] ~ 1017atoms·cm-3) diamond layer grown by CVD was irradiated using Ga+by FIB, with 1nA current and 5, 20, and 30 keV of acceleration voltage. The Ga+implanted diamond layer has been analysed through cathodoluminescence (CL) and scanning transmission electron microscopy (STEM)-related techniques. The beam penetration depth has been simulated by Monte Carlo calculations of both Ga+(FIB) and e-(CL) beams at different energies. The comparative CL analysis of the layer as-grown and after implantation revealed peaks related to defects, such as A band, H3 center, and defects present in the green band region. The STEM studies for the 30 keV implanted sample showed that the diamond lattice is affected by the damage, evidencing amorphisation in the layer with a sp2/sp3ratio of 1.37, estimated by EELS. Therefore, this study highlights the effects of the Ga+implantation on the optical and structural characteristics of diamond, using different methods.

On the Rapid Synthesis of Reduced Graphene Oxide via Ultrasound-Promoted Eco-Friendly Reduction Approach and Its Effects on Physicochemical Properties.

The common synthesis approach of reduced graphene oxide (rGO) using toxic reducing agents poses a threat to environmental pollution. This study used banana peel extract as a green reducing agent for the synthesis of rGO. Ultrasonication was assimilated to expedite the synthesis process. For comparison, rGO was also produced by reducing GO with hydrazine treatment under conventional stirring. Both morphological (SEM) and physicochemical (FTIR and XRD) studies have revealed that banana peel extract can reduce GO to rGO, although its reducing effect is much weaker compared to hydrazine. Despite this, the rGO produced using banana peel extract with the assimilation of ultrasonication technique has a greater interlayer spacing than that formed under the conventional stirring method. In terms of electrical properties, the electrical conductance of hydrazine-produced rGO (5.69 × 10-6 S) is higher than the banana peel extract-produced rGO (3.55 × 10-6 S - 4.56 × 10-6 S). Interestingly, it was found that most of the rGO produced by banana peel extract under ultrasound assistance has higher or comparable electrical conductance compared to the rGO produced by banana peel extract under stirring method. This implies the feasibility of using short-period ultrasound to replace conventional stirring in rGO synthesis.

A novel enucleation- exenteration approach of the equine eye via the supraorbital fossa: an experimental and clinical study in donkeys (Equus asinus).

This study investigated the description and feasibility of a surgical procedure for enucleation-exenteration of the equine eye via the supraorbital fossa. A preliminary study was performed on both eyes of four cadaveric heads of native breed donkeys (Equus asinus) to describe the surgical anatomy and demonstrate a new supraorbital enucleation surgical approach. For the clinical study, eight donkeys were admitted for unilateral enucleation. All procedures were performed in a lateral recumbent position under the influence of inhalation anesthesia in combination with a retrobulbar nerve block. A semi-circular incision was made in the skin and fascia of the supraorbital fossa to gain access into the orbital cavity, after which the periorbital fat was dissected and removed. Bleeding was controlled by electrocautery and large blood vessels were ligated, then the eyeball was dissected sharply and freed from its bony attachment. The procedure was successfully accomplished in all clinical cases, and no significant complications occurred during or throughout the postoperative follow-up period. The initial results suggest the feasibility and safety of the supraorbital enucleation technique described in this study for equine eye enucleation. This new technique seems promising due to its feasibility, safety, and positive outcomes observed in both cadaveric and clinical studies.

Thermo-activated in situ rectal gel preparation for Ibuprofen Using Eutectic Mixture.

This study aimed to develop a thermosensitive in situ gel formulation for rectal delivery of Ibuprofen as an efficient alternative dosage form. Utilizing poloxamer 188, poloxamer 407, and HPMC via cold technique method, a thermosensitive in situ gel was successfully prepared. The concentration of Ibuprofen in the formulations was 1.2% (w/w). The prepared gels underwent assessment for clarity, gelation temperature, gelation time, gel strength, spread ability, syringe-ability, pH, viscosity, FTIR, and drug content. The selected formulations exhibited a gelation temperature within the range of 30°C to 36°C, with consistent amount of drug soluble in the formulations (93% - 110%). Mucoadhesive studies, in vitro release tests, ex vivo modeling of drug release, kinetic studies modeling, and histopathology testing were also conducted. The formulation comprising 18% poloxamer 407, 12% poloxamer 188, and 1% sodium chloride (FS15) demonstrated suitable gelation temperature and desirable drug release rate. In vitro drug release tests indicated completion within one hour for both FS10 (20% P407 & 10% P188) and FS15 (18% P407 & 12% P188), with consistent and predictable release patterns observed through kinetic modeling analysis. Microscopic histopathology examination confirmed the safety of the selected formula, exhibiting no irritation in the mucosal membrane of the sheep. In conclusion, Ibuprofen thermosensitive in situ gel presents a promising and convenient strategy as a rectal carrier and an alternative dosage form to solid suppositories.

First Molecular Identification and Clinical Presentation of Crenosomosis in a Dog from Slovakia.

PURPOSE: Crenosoma vulpis (Dujardin,1845) is a lungworm which has spread worldwide in canines and is associated with upper respiratory infections. In a majority of cases, the infections are accompanied with chronic cough. Diagnosis of lungworms is often underdiagnosed and can be misinterpreted as other respiratory diseases. METHODS: The Small Animal Clinic of the University Veterinary Hospital admitted an 11-month-old dog presented with persistent cough associated with difficulty in breathing and even asphyxia. Based on clinical symptoms, the patient underwent radiological and bronchoscopic examination. Bronchoscopy revealed the presence of lungworms obturating the branches of the tracheobronchial tree. Larvae were collected by bronchoscopic lavage and subjected to parasitological and molecular examination. RESULTS: Microscopic detection and morphological identification of the worms removed during the bronchoscopy confirmed the presence of female adult worms. The subsequent molecular characterisation of the mitochondrial (cytochrome c oxidase subunit I gene (cox1) and 12S ribosomal DNA (rDNA)), nuclear (18S rDNA) genes, as well as the analysis of the second internal transcribed spacer (ITS-2) region of the ribosomal DNA, confirmed the Crenosoma vulpis species. Faecal samples were processed using the Baermann method, which confirmed the presence of the larval stage 1 of C. vulpis. The therapy with fenbendazole at a dose of 50 mg/kg of live weight once daily for the period of 7 days was initiated for the patient. CONCLUSION: This paper presents the first molecularly confirmed clinical case of a Crenosoma vulpis infection in an 11-month-old female dog of the Miniature Schnauzer breed in Slovakia.

A digital technique for occlusal design of a posterior full crown based on physiological tooth displacement and occlusion of adjacent teeth.

This article presents a digital technique to construct a virtual occlusion in the maximal intercuspal position (MIP), considering physiological tooth displacement and reducing intermesh penetrations between occlusal surfaces, in order to design more precise and accurate occlusal contacts of a posterior full crown.