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Is there a difference in the outcome of primary total knee arthroplasty performed using kinematic versus mechanical alignment?
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Clinical performance of 3d printed resin composite posterior fixed dental prosthesis a permanent solution
No full textObjectives: This clinical trial aimed to evaluate the clinical outcomes of 3D-printed resin composite posterior fixed dental prosthesis (FDP) restorations. Materials and Methods: Between October 2020 and August 2022, 49 patients (33 females, 16 males, aged 19-60) received 68 3-unit 3D-printed resin composite posterior FDPs (ELS Even Stronger, Saremco, Switzerland). Follow-ups were conducted at baseline (2 weeks) by independent observers using modified FDI criteria, assessing anatomical form, marginal adaptation, surface roughness, color match, fracture, retention, and patient feedback. Fifty FDPs completed a 1-year follow-up, and 18 reached 2 years. Results: The mean observation period was 14.15 months. Failures were categorized as mechanical or bio-logical, with 19 FDPs failing: 14 mechanical (12 cohesive fractures) and 5 biological (3 needing endodontic treatment, 2 periodontal issues). Two FDPs were recemented. Three FDPs showed surface luster loss, color mismatches, and staining. The survival rate based on mechanical failures was 69.5%, dropping to 61.0% when including biological com-plications. Conclusions: After 2 years, 3D-printed resin composite FDPs demonstrated acceptable performance, with most failures due to fractures in the connector region, suggesting the need for design revisions
Should patient activity be restricted after total hip, total knee, or unicondylar knee arthroplasty?
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AI for tobacco control: identifying tobacco-promoting social media content using large language models
No full textIntroduction: Tobacco companies use social media to bypass marketing restrictions. Studies show that exposure to tobacco promotion on social media influences subsequent smoking behavior, yet it is challenging to monitor such content. We developed an artificial intelligence that can automatically identify tobacco-promoting content on social media. Aims and Methods: In this mixed methods study, 177,684 tobacco-related tweets published on Twitter in Turkish were collected. Through inductive content analysis of a sample of 200 tweets, the main mechanisms by which tobacco is promoted on social media were identified. Then, a sample of 5000 tweets was deductively analyzed and labeled based on those mechanisms. A pre-trained transformer-based Large Language Model was fine-tuned using the labeled dataset. Then, tobacco promotion in all tweets was predicted using this model. Results: The main mechanisms of tobacco promotion on social media included modeling the behavior, expressing positive attitudes, recommending use, and marketing brands or vendors. The developed model identified tobacco-promoting social media content with 87.8% recall and 81.1% precision. The utility of the model was demonstrated in the analysis of tobacco promotion in tweets for a period of a month. Conclusions: This tool makes it possible to monitor tobacco promotion in social media and creates new opportunities for tobacco control policy and practice, not only in surveillance and enforcement but also in health promotion. Implications: Tobacco promotion in social media is a well-known yet hard-to-addressed problem due to the nature of social media. This study leverages a cutting-edge AI approach, Large Language Models, to identify tobacco promotion in social media content automatically and precisely. The developed model offers better prediction performance than previously proposed techniques. The study enables surveillance of tobacco-promoting content both for research purposes and enforcement of tobacco control measures. Furthermore, we suggest a range of health promotion opportunities this tool can help with from developing personal skills to creating supportive environments and strengthening community actions.Turkish Green Crescent Societ
Spark plasma sintering of B4C-TiB2 composite: effect of combustion synthesized nanoparticle on sinterability and mechanical properties
No full textThis study investigated the effects of fine particles with high surface area synthesized by Self-propagating High-Temperature Synthesis (SHS) on the SPS process and the properties of the resulting products. Correlations were established between particle size, SHS product addition, sinterability, and mechanical properties. The products were characterized by measuring shrinkage percentages, relative density, microhardness, elastic modulus, and fracture toughness, which were further correlated with SEM–EDS results. The results revealed that SHS nanoparticles significantly increased fracture toughness, especially with additions above 60%, by reducing average particle size, increasing powder porosity, and adding composite powder. The product exhibited high relative density (99.03%), elastic modulus (464 GPa), and fracture toughness (4.65 MPa.m1/2) when SPS was used on B4C-TiB2 powders containing 80% SHS product at a low temperature of 1550 °C. By adding 80% SHS product, hardness increased by 62% (19.5 GPa) and fracture toughness by 24%, even at low sintering temperatures, thus reducing energy consumption.Istanbul Gedik University ; Spark Plasma Sinterin
Evaluation of the frequency of restless legs syndrome in children diagnosed with allergic diseases
No full textObjective: We aimed to determine the frequency of restless legs syndrome (RLS) in children with allergic diseases. Methods: The age, gender, height, weight, BMI z-scores, and laboratory values of children diagnosed with asthma, allergic rhinitis, atopic dermatitis, and chronic urticaria, as well as a healthy control group, were examined. RLS was assessed using a questionnaire based on the diagnostic criteria of the International Restless Legs Syndrome Study Group. Neurological examination findings, questionnaire results, and RLS severity scores were evaluated by a pediatric neurology specialist. Results: The study evaluated data from 270 children diagnosed with allergic diseases and 150 healthy controls. Both groups were statistically similar in terms of age, gender, weight, height, and BMI z-scores (p > 0.05). The frequency of RLS was reported as 13.3% in children with allergic airway disease, 15.5% in those with allergic skin disease, and 6.7% in the control group. The frequency of RLS in children with allergic airway disease and allergic skin disease was significantly higher compared to the control group (p = 0.041 and p = 0.022, respectively). The frequency of mild RLS in children with allergic diseases and the control group was 43.6% (n = 17) and 50% (n = 5), respectively (p = 0.737). The rate of females with RLS was significantly higher than those without RLS (69.2% vs. 30.8%) (p = 0.045). According to logistic regression analysis, individuals with allergic diseases were 2.307 (95.0% CI of OR 1.087 to 4.897) times more likely to develop RLS compared to those without allergic diseases (p = 0.029). Conclusion: The frequency of RLS is higher in children with allergic diseases. Early diagnosis of RLS may allow for a holistic management of quality-of-life-reducing problems, such as sleep disorders, that may be associated with both conditions
Evaluation of flexural strength of additively manufactured resin materials compared to auto-polymerized provisional resin with and without hydrothermal aging
No full textPurpose: Additive manufacturing (AM) technologies are used to fabricate 3D-printed provisional dental restorations. The purpose of this study was to investigate the flexural strength of 3D-printed resins and compare their mechanical performance with those of conventional resins indicated for provisional restorations. Materials and methods: This study included six different 3D-printed resin materials, namely (Nextdent (ND); Temp PRINT (TP); Optiprint temp (OT); 3Delta Etemp (DE); Saremco print | CROWNTEC (SA); MED690 (ST)), and one conventional (Protemp (PT)) (Control) provisional resin material. Specimens (N = 168) were prepared (25x2x2 mm3) following ISO 10477:2018 guidelines for temporary materials using a printer (Asiga MAX 3D). Post-processing was accomplished following each manufacturer's recommendation. While half of the specimens were tested after 24 H without aging, the other half was subjected to thermomechanical aging in a custom-made chewing simulator (1.200.000 cycles, 5 °C and 55 °C). Flexural strength of the specimens was determined using a Universal Testing Machine. Data were analyzed using two-way ANOVA followed by Tukey's post-hoc test (α = 0.05). Weibull modulus for each group was calculated based on parametric distribution analysis of censored data for maximum fracture load. Results: No significant difference was observed in mean flexural strength (MPa) when non-aged and aged conditions were compared in the OT and PT groups (p>0.05). Groups ND, SA, TP, DE, and ST presented significant differences ranging between 12.67 and 57.39 MPa (p<0.05). All groups presented lower shape and scale values in aged groups compared to their non-aged counterparts. While OT and PT maintained their flexural strength after aging, ND exhibited the highest decrease (30%), followed by DE (23.8%), SA (16.2%), TP (12%), and ST (8.6%) in descending order. Weibull modulus decreased as a function of aging except in group ST. Conclusion: Significant effect of themomechanical aging especially on ND and DE materials should be considered with caution when such materials are indicated as interim or long-term interim provisional restorations. SA and TP exceeded the expectations from a provisional material compared to that of the conventional control material PT
Sex differences in clinical and polysomnographic features of obstructive sleep apnea: The Turkish sleep apnea database (TURKAPNE) cohort
No full textBackground: Previous reports from relatively small clinical cohorts have suggested that the clinical presentation of obstructive sleep apnea (OSA) differs between men and women. Objective: We aimed to explore sex differences in clinical and polysomnographic features of OSA in a large nationwide registry. Methods: Participants from the ongoing Turkish Sleep Apnea Database (TURKAPNE) Study from 34 centers were included in the current analysis. OSA was defined as an apnea-hypopnea index (AHI) ≥5 events/hour and was classified as mild, moderate, and severe according to AHI cut-offs 5, 15, and 30 events/hour, respectively. Results: In all, 7130 patients (2259 women) were included. OSA was observed in 6323 (88.7 %), of whom 70.2 % were male and 29.8 % were female. In the OSA group, women were older (56.7 ± 11.9 vs. 49.5 ± 11.3 years; p < 0.001) and more obese (body mass index 34.3 ± 7.2 vs. 31.4 ± 5.6 kg/m2; p < 0.001) and had lower AHI (29.8 ± 24.1 vs. 36.8 ± 26.2 events/h; p < 0.001) than men. Loud snoring and witnessed apnea were more common in men than in women whereas women were more frequently presented with insomnia, headache, and mood changes. Women had significantly less total sleep time, less sleep efficiency, and longer sleep latency compared with men (p < 0.001 for each). Additionally, comorbid diseases such as diabetes mellitus, hypertension, asthma, psychiatric disorders, hypothyroidism as well as drug use were more common in women than in men independent of age and obesity (p < 0.05 for each). Conclusions: Our results suggest significant sex differences in clinical and polysomnographic features in this nationwide Turkish adult population. Women with OSA have more symptom burden and comorbidities despite having a less severe AHI.Turkish Thoracic Societ
Innovative approaches to green digital twin technologies of sustainable smart cities using a novel hybrid decision-making system
No full textDigital twin technologies play a very important role in the provision of smart cities. However, it is not clear which innovative strategies should be implemented first on how to optimize digital twin technologies for sustainable smart cities. The main performance indicators should be identified to use the limited resources more efficiently and to generate more effective investment strategies. Accordingly, the purpose of this study is to generate innovative approaches to green digital twin technologies of sustainable smart cities. To achieve this issue, first, important criteria of digital twin technologies for assessing sustainable smart cities are weighted via spherical fuzzy simple weight calculation (SIWEC). The second part includes ranking innovative alternatives for green digital twin technologies by considering spherical fuzzy simple additive weighting (SAW). The main contribution of this manuscript is to identify the most effective investment strategies for the improvements of digital twin technologies to reach smart cities by establishing a novel model. The preference of the SIWEC method in the criteria weighting process provides some advantages to the model. The most important feature of this method is that the direct importance of the criterion is taken into consideration in the questions asked to the experts. In this way, it is possible for the experts to give more sensitive answers. The findings indicate that smart grid integration (weight: 0.231) is determined as the most important criterion in the development of digital twin technologies for the provision of smart cities. Circular economy (weight: 0.230) is another variable that plays an important role in the provision of smart cities. On the other hand, decentralized energy system with microgrids is found as the most important alternative for this situation. Some critical actions should be taken to improve the smart grid effectiveness. In this scope, providing renewable energy incentives has a strong influence on the improvements of these projects.National Social Science Fund of Chin
Comparison of postoperative analgesic efficacy between erector spinae plane block and rhomboid intercostal block in breast-conserving surgery and sentinel lymph node biopsy: a randomized non-inferiority clinical trial
No full textObjectives: Breast-conserving surgery is a common breast operation type in the world. Patients may feel severe postoperative pain after the surgery. Several regional anesthesia methods are used for postoperative pain control as a part of multimodal analgesia management after breast surgery. Erector spinae plane block (ESPB) and rhomboid intercostal plane block (RIB) are commonly used techniques for this purpose. The studies that compare these methods are limited. Therefore, we aimed to compare the efficacy of ESPB and RIB. Methods: This prospective, randomized study included sixty female patients with ASA class I-II physical status in the study. All patients underwent general anesthesia. We performed the blocks at the end of the surgery before extubation. Participants were randomized into two groups between the operation: the Group ESPB (n=30) and the Group RIB (n=30). We performed 30 ml volume of 0.25% bupivacaine for the blocks. 400 mg ibuprofen 3x1 was ordered postoperatively, and a fentanyl PCA device (2 ml bolus, 0 ml infusion, 20 min lock time, 4 hour limit) was attached intravenously to the participants. If the pain score was ≥4, meperidine (0.5 mg/kg) was performed. Results: There were no differences in terms of demographical data. The postoperative opioid use, pain scores, adverse events, and the need for rescue analgesia were similar between groups. Conclusion: Both RIB and ESPB are effective regional anesthesia techniques following breast surgery. They are simple and safe methods. Anesthesiologists may prefer one or the other based on their clinical experience