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Nanoindentation creep: The impact of water and artificial saliva storage on milled and 3D-printed resin composites.
No full textPURPOSE
This study evaluated the effects of artificial saliva and distilled water on the nanoindentation creep of different 3D-printed and milled CAD-CAM resin composites.
MATERIAL AND METHODS
Disk-shaped specimens were subtractively fabricated from polymer-infiltrated ceramic network (EN) and reinforced resin composite (B) and additively from resin composite (C) and hybrid resin composite (VS) using digital light processing (DLP). Specimens from each material were divided into two groups according to their storage conditions (artificial saliva or distilled water for 3 months). Creep was analyzed by nanoindentation testing. Statistical analysis was done using two-way ANOVA, one-way ANOVA, Bonferroni post hoc tests, and independent t-test (α = 0.05).
RESULTS
The main effects of material and storage conditions, and their interaction were statistically significant on nanoindentation (p < 0.001). Storage condition had the greatest influence (partial eta squared ηP 2 = 0.370), followed by the material (ηP 2 = 0.359), and the interaction (ηP 2 = 0.329). The nanoindentation creep depths after artificial saliva storage ranged from 0.34 to 0.51 µm and from 0.50 to 0.87 µm after distilled water storage. One of the additively manufactured groups had higher nanoindentation creep depths in both storage conditions.
CONCLUSIONS
All specimens showed comparable performance after artificial saliva storage, but increased nanoindentation creep after distilled water storage for 3 months. The subtractive CAD-CAM blocks showed superior dimensional stability in terms of nanoindentation creep depths in both storage conditions. Additively manufactured composite resins had lower dimensional stability than one of the subtractively manufactured composites, which was demonstrated as having higher creep deformation and maximum recovery. However, after artificial saliva storage, one of the additively manufactured resins had dimensional stability similar to that of subtractively manufactured
Odynophagia and Retrosternal Pain Are Common in Eosinophilic Esophagitis and Associated with an Increased Overall Symptom Severity.
Get PDFBACKGROUND AND AIMS
Dysphagia is the hallmark symptom in eosinophilic esophagitis (EoE). However, data are limited regarding the overall prevalence and potential implications of atypical symptoms like odynophagia and retrosternal pain.
METHODS
Patients enrolled into the Swiss EoE cohort study (SEECS) were analyzed regarding the presence of odynophagia and retrosternal pain. Demographics, other EoE-related symptoms, histologic and endoscopic activity were compared between EoE-patients with vs. without odynophagia and/or retrosternal pain.
RESULTS
474 patients (75.2% male) were analyzed. In their individual course of disease 110 (23.2%) patients stated to have ever experienced odynophagia and 64 (13.5%) retrosternal pain independent of food intake, 24 (5%) patients complained about both symptoms. Patients with odynophagia consistently scored higher in symptom severity (p < 0.001), EREFS score (median 3.0 vs. 2.0, p = 0.006), histologic activity and a lower quality of life (p = 0.001) compared to patients without odynophagia. Sex, age at diagnosis, EoE-specific treatment, complications such as candida or viral esophagitis and disease duration were similar in patients with vs. without odynophagia. Also patients with retrosternal pain scored higher in symptom severity (2.0 vs. 1.0, p = 0.001 and 2.0 vs. 1.0, p < 0.001 in physician and patient questionnaire assessment, respectively). However, there was neither a difference in endoscopic/histologic disease activity nor in quality of life according to presence or absence of retrosternal pain. Due to logistic reasons, a stratification regarding the presence of concomitant dysphagia was not possible.
CONCLUSION
Odynophagia and swallowing-independent retrosternal pain are common symptoms in patients with EoE, associate with an overall higher EoE-related symptom severity and for the case of odynophagia lower quality of life. However, the influence of concomitant dysphagia and its severity remains unclear and needs to be included in future analyses
Comparing image normalization techniques in an end-to-end model for automated modic changes classification from MRI images
Get PDFIntroduction
Modic Changes (MCs) are MRI alterations in spine vertebrae's signal intensity. This study introduces an end-to-end model to automatically detect and classify MCs in lumbar MRIs. The model's two-step process involves locating intervertebral regions and then categorizing MC types (MC0, MC1, MC2) using paired T1-and T2-weighted images. This approach offers a promising solution for efficient and standardized MC assessment.
Research question
The aim is to investigate how different MRI normalization techniques affect MCs classification and how the model can be used in a clinical setting.
Material and methods
A combination of Faster R–CNN and a 3D Convolutional Neural Network (CNN) is employed. The model first identifies intervertebral regions and then classifies MC types (MC0, MC1, MC2) using paired T1-and T2-weighted lumbar MRIs. Two datasets are used for model development and evaluation.
Results
The detection model achieves high accuracy in identifying intervertebral areas, with Intersection over Union (IoU) values above 0.7, indicating strong localization alignment. Confidence scores above 0.9 demonstrate the model's accurate levels identification. In the classification task, standardization proves the best performances for MC type assessment, achieving mean sensitivities of 0.83 for MC0, 0.85 for MC1, and 0.78 for MC2, along with balanced accuracy of 0.80 and F1 score of 0.88.
Discussion and conclusion
The study's end-to-end model shows promise in automating MC assessment, contributing to standardized diagnostics and treatment planning. Limitations include dataset size, class imbalance, and lack of external validation. Future research should focus on external validation, refining model generalization, and improving clinical applicability
Evaluation of the 2021 ESC recommendations for family screening in hereditary transthyretin cardiac amyloidosis.
Get PDFAIMS
The 2021 European Society of Cardiology (ESC) screening recommendations for individuals carrying a pathogenic transthyretin amyloidosis variant (ATTRv) are based on expert opinion. We aimed to (i) determine the penetrance of ATTRv cardiomyopathy (ATTRv-CM) at baseline; (ii) examine the value of serial evaluation; and (iii) establish the yield of first-line diagnostic tests (i.e. electrocardiogram, echocardiogram, and laboratory tests) as per 2021 ESC position statement.
METHODS AND RESULTS
We included 159 relatives (median age 55.6 [43.2-65.9] years, 52% male) at risk for ATTRv-CM from 10 centres. The primary endpoint, ATTRv-CM diagnosis, was defined as the presence of (i) cardiac tracer uptake in bone scintigraphy; or (ii) transthyretin-positive cardiac biopsy. The secondary endpoint was a composite of heart failure (New York Heart Association class ≥II) and pacemaker-requiring conduction disorders. At baseline, 40/159 (25%) relatives were diagnosed with ATTRv-CM. Of those, 20 (50%) met the secondary endpoint. Indication to screen (≤10 years prior to predicted disease onset and absence of extracardiac amyloidosis) had an excellent negative predictive value (97%). Other pre-screening predictors for ATTRv-CM were infrequently identified variants and male sex. Importantly, 13% of relatives with ATTRv-CM did not show any signs of cardiac involvement on first-line diagnostic tests. The yield of serial evaluation (n = 41 relatives; follow-up 3.1 [2.2-5.2] years) at 3-year interval was 9.4%.
CONCLUSIONS
Screening according to the 2021 ESC position statement performs well in daily clinical practice. Clinicians should adhere to repeating bone scintigraphy after 3 years, as progressing to ATTRv-CM without signs of ATTRv-CM on first-line diagnostic tests or symptoms is common
Asymmetries of the subthalamic activity in Parkinson's disease: phase-amplitude coupling among local field potentials.
Get PDFThe role of brain asymmetries of dopaminergic neurons in motor symptoms of Parkinson's disease is still undefined. Local field recordings from the subthalamic nucleus revealed some neurophysiological biomarkers of the disease: increased beta activity, increased low-frequency activity and high-frequency oscillations. Phase-amplitude coupling coordinates the timing of neuronal activity and allows determining the mechanism for communication within distinct regions of the brain. In this study, we discuss the use of phase-amplitude coupling to assess the differences between the two hemispheres in a cohort of 24 patients with Parkinson's disease before and after levodopa administration. Subthalamic low- (12-20 Hz) and high-beta (20-30 Hz) oscillations were compared with low- (30-45 Hz), medium- (70-100 Hz) and high-frequency (260-360 Hz) bands. We found a significant beta-phase-amplitude coupling asymmetry between left and right and an opposite-side-dependent effect of the pharmacological treatment, which is associated with the reduction of motor symptoms. In particular, high coupling between high frequencies and high-beta oscillations was found during the OFF condition (P < 0.01) and a low coupling during the ON state (P < 0.0001) when the right subthalamus was assessed; exactly the opposite happened when the left subthalamus was considered in the analysis, showing a lower coupling between high frequencies and high-beta oscillations during the OFF condition (P < 0.01), followed by a higher one during the ON state (P < 0.01). Interestingly, these asymmetries are independent of the motor onset side, either left or right. These findings have important implications for neural signals that may be used to trigger adaptive deep brain stimulation in Parkinson's and could provide more exhaustive insights into subthalamic dynamics
Simultaneous EEG-fMRI at 7T with adapted EEG leads and reference sensors for high-quality, high-resolution imaging: human evaluation
No full textSimultaneous T1 and T2 mapping of the brain with accelerated QuantoRAGE using optimized sequence parameters and fast neuralnetwork fitting
No full textPatchSorter: a high throughput deep learning digital pathology tool for object labeling.
Get PDFThe discovery of patterns associated with diagnosis, prognosis, and therapy response in digital pathology images often requires intractable labeling of large quantities of histological objects. Here we release an open-source labeling tool, PatchSorter, which integrates deep learning with an intuitive web interface. Using >100,000 objects, we demonstrate a >7x improvement in labels per second over unaided labeling, with minimal impact on labeling accuracy, thus enabling high-throughput labeling of large datasets
Assessing the use of sodium-glucose cotransporter 2 inhibitor in patients with type 2 diabetes mellitus and chronic kidney disease in tertiary care: a SwissDiab Study.
Get PDFINTRODUCTION
The overall aim of this study was to evaluate the implementation of sodium-glucose cotransporter 2 inhibitors (SGLT2i) among patients in tertiary care with type 2 diabetes mellitus (T2DM) and chronic kidney disease (CKD).
RESEARCH DESIGN AND METHODS
The cross-sectional analysis was based on outpatients in tertiary diabetes care enrolled in the Swiss Diabetes Registry with T2DM and a study visit January 1, 2020-March 31, 2021. Prevalence of CKD was ascertained as an estimated glomerular filtration rate <60 mL/min/1.73 m2 and/or persistent albuminuria as defined by Kidney Disease Improving Global Outcomes, and the proportion of patients prescribed SGLT2i was determined. Documented reasons for non-treatment with SGLT2i were extracted by a retrospective review of the medical records.
RESULTS
Of 368 patients with T2DM, 1.1% (n=4) were excluded due to missing data. Of the remaining 364 patients, 47.3% (n=172) had CKD of which 32.6% (n=56) were prescribed SGLT2i. The majority (75%) of these patients were on treatment already in 2018, before the renoprotective effects of SGLT2i were established. Among the 116 patients without SGLT2i, 19.0% had known contraindications, 9.5% stopped treatment due to adverse events, 5.2% had other reasons, and no underlying reason for non-treatment could be identified for 66.4%.
CONCLUSIONS
A divergence between recommended standard of care and implementation in daily clinical practice was observed. Although treatment should always consider patient-specific circumstances, the results highlight the need to reinforce current treatment recommendations to ensure patients benefit from the best available care
Sealskins, Scales and Silken Hair: Transformability as Resistance in Merfolk Literature
No full textIn this contribution, hydro-protean figures such as mermaids and selkies will be considered
through the lens of littoral studies, highlighting the transformative capacities of both the
imaginary creature and the beach. Expressing and embodying continuous shifting and flowing,
they both resist clear boundaries and categorisation. As a “liminal zone,” the beach is
destabilising in both the material and metaphorical sense, a fluctuating threshold “between land
and the sea, as well as nature and culture” (Kluwick and Richter 2015). Similarly, the hybridity
of mermaids (fish-human) and selkies (seal-human) challenges hegemonic dualisms such as
nature/culture and animal/human since they are neither and both simultaneously. As such,
both the beach and merfolk can serve as a model for recognising “a complex, interacting pattern
of both continuity and difference” which resists the domination inherent in colonial, capitalist
and patriarchal power structures (Plumwood 1993). Thinking with the littoral and with merfolk
means considering fluidity, transformation and connection as a basis rather than an alternative
for life on a multi-species planet. To illustrate my argument, I will demonstrate how Lagoon by
Nnedi Okorafor (2014) combines littoral zones, protean entities and parallel narratives with
multiple focalisers to create an Africanfuturist vision of entangled multi-species survival
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