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关键词： CAD   tuberculosis   chest ultrasound   Ethiopia   Africa   diagnosis   CAD4TB   pulmonary tuberculosis  

摘要： Introduction Early and accurate diagnosis of pulmonary tuberculosis (TB) is crucial for timely treatment and prevention of transmission, but diagnostic challenges persist due to complex symptoms and limitations in diagnostic tools. Chest X-ray (CXR) is the standard imaging modality, but its sensitivity and specificity may vary. Recently, some promising alternatives emerged such as chest ultrasonography (CUS) - particularly valuable in resource-limited settings - and computer-aided diagnosis (CAD) systems - helping clinicians in the reading and interpretation of the CXR. However, direct comparisons of CUS, CXR, and CAD score in TB diagnosis are limited. Methods and analysis This cross-sectional study will assess the diagnostic effectiveness of CUS in diagnosing TB compared to CXR and CAD score among index cases and household contacts. The study will be conducted at Wolisso St. Luke Hospital (Wolisso, Ethiopia). Index cases will be subjects with diagnosis of pulmonary tuberculosis within 7 days. Household contacts will be identified by administering a screening questionnaire to index cases. They will undergo CXR as for standard of care and consequent CAD analysis and CUS. The anticipated sample size is 136 subjects. The common accuracy metrics (sensitivity, specificity, positive and negative predictive values) will be calculated. Ethics and dissemination The protocol was approved by the Oromia Health Bureau Research Ethics Committee (BFO/MBTFH/1-16/1908). All information obtained will be confidential. Selected investigators will have access to data, while international partners will sign a dedicated Data Protection Agreement. Eligible subjects will receive a brief information about the study before being asked to participate and they will provide a written informed consent. Results will be conveyed to stakeholders and disseminated through conferences and peer-reviewed journals.

摘要： Herein, we demonstrated maleimide-based conjugation chemistry to achieve the site-specific covalent immobilization of the C334A mutant of Cytochrome P450cam (C334A CYP101) onto a gold electrode. To be specific, firstly electrode surface was functionalized with maleimide groups involving cysteamine and N-(4-Carboxyphenyl) maleimide (p-CPMI) via a facile two-step process. The enzyme's accessible cysteine residues (C58 and C136) in the phosphate buffer solution (pH 7.4) containing CYP101 employed for the covalent attachment of C334A CYP101 through a chemoselective reaction with the maleimide moieties on the p-CPMI-modified electrode. The electrochemical analysis of the immobilized enzyme on a functionalized gold electrode was performed through Cyclic Voltammetry (CV) measurement. The enzyme-modified electrode exhibited a mid-point potential of -350 ± 10 mV vs Ag/AgCl in 3 M KCl aqueous electrolyte, indicating efficient electron transfer between the enzyme and the electrode interface. This strategy for site-specific immobilization holds considerable promise for diverse electrocatalytic applications, including the enzymatic detoxification of environmental pollutants and the synthesis of high-value chemical compounds, by exploiting the catalytic efficiency of C334A CYP101.

关键词： Dietary supplements   General practice   Cross-sectional   Survey   CAM  

摘要： BackgroundDietary supplements (DS) are often used by patients to enhance their health and well-being. General practitioners (GPs) are commonly the first point of contact for patients who enquire about DS. The aim of this study was to explore GPs' views on *** cross-sectional purposeful recruitment online survey of 162 general practitioners (GPs) in Germany was conducted between May and August 2021. The questionnaire assessed GPs' views on dietary supplements (DS), including perceptions of safety, efficacy, and importance in medical practice. Data were analyzed using inferential statistics and logistic regression analyses to explore associations between GPs' views and demographic *** rate could not be determined because multipliers were included here by means of personal networks, consent rate was 100%. Many respondents considered DS to be an important topic in their daily practice (64,8%, n = 99). Almost two thirds were convinced of their efficacy and considered DS to be safe for use (61,2%, n = 93). However, the majority of respondents were in favor of more standardized guidelines (86.8%, n = 132) and improved medical education on the handling of DS in routine care (89,5%, n = 136). Physicians who self-administered DS were statistically significantly more likely to perceive them as safe to use, with an OR of 4.25 (95% CI: 1.74-10.40). Self-administration [OR 4.52 (1.67-12.22)] and participation in continuous medical education (CME) [OR 3.52 (1.133-9.38)] were positively associated with perceiving them as an important *** the best of our knowledge, this is the first study to assess German GPs' perceptions regarding DS. The majority of physicians recognized the importance of DS in routine care but wished for improved regulation and more standardized guidelines regarding their use. The findings could be used to develop targeted educational interventions and improve handling of DS in daily general practice. General practition

摘要： Background Hematocrit (HCT) is an important indicator of anemia and blood oxygen-carrying capacity. However, evidence is scarce on the long-term prognostic value of HCT in patients with coronary artery disease (CAD). This study was to clarify this...

关键词： Computer-aided design   In vitro   Microleakage   Prefabricated zirconia crowns   Primary teeth  

摘要： The durability of pediatric zirconia crowns for primary teeth is influenced by the choice of luting cement, with the effectiveness of the cement being directly correlated to its ability to reduce microleakage. This in vitro study aimed to assess and compare the microleakage of custom-made zirconia crowns (CZCs) and prefabricated zirconia crowns (PZCs) on primary maxillary incisors when luted with self-adhesive resin cement, resin-modified glass ionomer cement (RMGIC), and bioactive cement. Sixty primary maxillary incisors were prepared and allocated into two groups, each corresponding to the two types of crowns. These groups were further divided into three subgroups each to test the different luting cements. Following the cementation process and thermocycling, the specimens were immersed in a 2% methylene blue solution for microleakage evaluation. The analysis involved sectioning the teeth and examining them under a stereomicroscope. Statistical analysis, using two-way ANOVA and post hoc Dunnett T3 tests (p < 0.05), revealed significant differences in microleakage among the cements. The study found that PZCs luted with RMGIC showed the highest level of microleakage, whereas those luted with bioactive cement exhibited the lowest, positioning bioactive cement as the preferable choice for minimizing microleakage. This finding illustrates the critical importance of selecting appropriate luting cements to optimize the clinical outcomes of zirconia crown restorations in pediatric dentistry, focusing on reducing microleakage to ensure the restoration's durability and success.

关键词： atrial fibrillation   digital devices   photoplethysmography   rhythm monitoring   screening   wearables  

摘要： Aim: A recent European Heart Rhythm Association (EHRA) practical guide provides guidance on the use of novel digital devices for heart rhythm analysis using either electrocardiogram (ECG) or photoplethysmography (PPG) technology for the diagnosis of atrial fibrillation (AF). This survey assesses physicians' preferences to use digital devices in patients with possible AF and their impact on clinical decision-making. Methods and Results: Participants of the DAS-CAM III initiated and distributed an online survey assessing physician preferences in using digital devices for the management of AF in different clinical scenarios. A total of 505 physicians (median age: 38 [IQR 33-46] years) from 30 countries completed the survey. A third of respondents were electrophysiologists, the others were cardiologists, cardiology residents, or general practitioners. Electrophysiologists were more likely to have experience with both ECG-based (92% vs. 68%, p < 0.001) and PPG-based (60% vs. 34%, p < 0.001) digital devices. The initial diagnostic approach to each scenario (symptomatic low-risk, symptomatic high-risk, or asymptomatic high-risk patient) was heterogeneous. Electrophysiologists preferred intermittent single-lead ECG monitoring to traditional Holter ECGs to screen for AF. Both electrophysiologists and non-electrophysiologists would rarely use PPG-based devices to diagnose and screen for AF (8.2%-9.8%). Electrophysiologists and non-electrophysiologists use ECG-based technology to confirm PPG-documented tracings suggestive of AF. Conclusion: While PPG-based digital devices are rarely used for diagnosis and screening for AF, intermittent ECG-based digital devices are beginning to be implemented in clinical practice. More education on the potential of novel digital devices is required to achieve diagnostic pathways as suggested by the EHRA practical guide.

关键词： diabetes mellitus   dual antiplatelet therapy   high bleeding risk   percutaneous coronary intervention   APT   antiplatelet therapy   CAD   coronary artery disease   CVA   cerebrovascular accident   DAPT   dual antiplatelet therapy   DB   diabetes mellitus   MACE   major adverse clinical event(s)   MACCE   major adverse cardiac and cerebral event(s)   MCB   major or clinically relevant nonmajor bleeding   MI   myocardial infarction   NACE   net adverse clinical event(s)   OAC   oral anticoagulation   PCI   percutaneous coronary intervention   SAPT   single antiplatelet therapy   ST   stent thrombosis  

摘要： Abbreviated antiplatelet therapy (APT) reduces bleeding without increasing ischemic events in largely unselected high bleeding risk (HBR) patients undergoing percutaneous coronary intervention (PCI). Diabetes mellitus (DM) is associated with higher ischemic risk, and its impact on the safety and effectiveness of abbreviated APT in HBR PCI patients remains unknown.

关键词： CAD-CAM   Dynamic occlusion   Intraoral scanner   Occlusal adjustment   Occlusal interferences  

摘要： BackgroundDesigning the occlusal surface of a prosthesis to ensure optimal eccentric occlusion is challenging without precisely replicating the patient's mandibular movements. During the CAD-CAM prosthesis delivery process, clinicians often need to make adjustments to the prosthesis to avoid occlusal interferences that may occur during lateral excursions. Recently, there have been developments in the field of mandibular motion tracking using optical devices. These approaches seek to incorporate an individual's functional movement into the research field of occlusal *** study aimed to assess the accuracy of digitally replicating mandibular movements to identify and correct occlusal interferences in monolithic CAD-CAM zirconia *** intraoral scanner (IOS) was used to capture complete arch maxillary and mandibular teeth and record buccal and lateral interocclusal records of maxillary first premolar abutment teeth of thirteen participants. For each patient, two monolithic zirconia crowns were fabricated following the standard digital workflow. The crowns were categorized based on the virtual method used for adjusting occlusal interferences into two groups: Group I, where occlusal interferences in CAD-CAM zirconia crowns were adjusted using buccal interocclusal records, and Group II, where adjustments were made using both buccal and lateral interocclusal records. After crown fabrication following the manufacturer's instructions, occlusion was analyzed using an electronic pressure analyzer. The mean, standard deviation and median values of the recorded data were measured. Paired t test and Wilcoxon Sign Rank test were executed for analyzing differences between groups (p value <= 0.05).ResultsGroup I recorded higher maximum pressure at lateral mandibular movement with mean +/- standard deviation value of 26.00 +/- 4.95% than Group II with 20.62 +/- 3.38%. Regarding pressure recorded at maximum intercuspation (MI) Group I showed higher results;8.0

关键词： denture teeth   flexural strength   surface roughness   thermocycling  

摘要： Purpose: To assess the flexural strength (FS), surface roughness, and color stability of additive manufactured (AM) and subtractive manufactured (SM) denture teeth materials, as well as the effect of thermocycling on these properties. Materials and Methods: Eighty strips (20/material type;64x10x3.3 mm) and 60 discs (15/material type;12x4 mm) were fabricated from four different denture teeth materials (Straumann, Flexcera, Ivoclar, and Candulor). The specimens were divided into two subgroups (nonthermal cycled and 5000 thermal cycled,10 per subgroup), and subjected to a 3-point test for FS using a universal testing machine at a crosshead speed of 5.0 mm/min. Surface roughness (R-a, mu m) and color differences (Delta E-00) of disc specimens were measured before and after thermocycling using a noncontact optical profilometer and a spectrophotometer, respectively. The CIEDE2000 formula was used to calculate the color differences (Delta E-00) before and after thermocycling. Data were analyzed using 2-way ANOVA followed by post hoc multiple comparison tests (alpha = 0.05). Results: There was no significant difference in flexural strength between nonthermal cycled SM materials (p = 0.15), which were significantly higher than AM materials (p < 0.001). The flexural strength values of all tested materials were significantly reduced after thermocycling (p < 0.05). The material type had a significant effect on the R-a values (p < 0.001), whereas thermocycling did not (p = 0.81). After thermocycling, all materials exhibited color changes lower than the clinical perceptible threshold (Delta E-00 = 2.7). Conclusions: Thermocycling decreased the FS of denture teeth materials manufactured with AM and SM, but did not affect the surface roughness. The FS values of SM groups were significantly higher than AM materials, irrespective of thermocycling. No clinically significant color changes of the denture teeth material were noted.