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关键词： mandibular reconstruction   patient-specific   3D-printing   titanium plate   miniplate   fibula flap   pseudarthrosis   CAD/CAM  

摘要： Objective Miniplates offer superior clinical handling and facilitate postoperative removal after mandibular reconstruction but unfavorable load distribution under high stress has been shown. This study aimed to compare the clinical outcome of patient-specific 3D-printed (PS-3D) titanium miniplate with reconstruction plate fixation in three-segmental LCL-type reconstructions for the first *** Patients undergoing three-segmental LCL-type mandibular reconstruction after malignant tumor resection between April 2017 and July 2023 were analyzed in a retrospective single-center study. Inclusion criteria were primary reconstruction using a fibula free flap and PS-3D titanium mini- or reconstruction plate fixation. Complication rates were recorded and analyzed within 6 months after surgery using the N - 1 Chi2- and unequal variance *** 38 patients (10 females, 28 males;mean age 61.4 +/- 7.6 years) met the inclusion criteria. In 14 patients (36.8%) miniplates were used in the anterior region. Rates of fixation failure, plate exposure, incomplete osseous union, wound infection, soft tissue, and overall complications did not differ significantly between the two plate *** Complication rates did not differ significantly between PS-3D mini- and reconstruction plates in three-segmental LCL-type mandibular reconstructions. Given their advantages in clinical handling and postoperative removal, PS-3D miniplates can be a viable alternative also in larger mandibular reconstructions.

关键词： Homeless   Shelter   Emergencies   Engineering   Industrial engineering   CAD   CAE  

摘要： The divide between the rich and poor in the European housing market is fast rising. Latest research indicates that Europe is dealing with an increasing number of homeless people. Every city in Europe has them-homeless people compelled to live on street corners, frequently hiding themselves with cardboard. Rain, snow, and temperatures below zero pose a threat to their lives on a daily basis. There are many varied kinds of services that have been discovered, but it is difficult to keep track of everyone and guarantee that they have a warm night's sleep in the winter. The current article suggests accommodation as a workaround until they can receive high-intensity support, a way to keep a single person warm and safe during the winter. The focus is on devising a strategy that not only ensures the warmth and safety of individuals during the harsh winter months but also seeks to industrialize the construction of shelters, ensuring affordability below the cost of winter hospitalization for a homeless person. Crucially, the article introduces an additional layer to this initiative by highlighting the dual purpose of these individual shelters. Beyond being a means to provide respite for the homeless during severe weather, these shelters are envisioned as immediate response units in the event of emergencies such as earthquakes in urban areas. The article explores the potential impact of this multi-layered approach on transforming urban landscapes and fostering resilient communities.

关键词： computed tomography   coronary artery disease   fractional flow reserve   ischemia   1D   1-dimensional   3D   3-dimensional   DS   percent diameter stenosis   CAD   coronary artery disease   CCTA   coronary computed tomography angiography   CFD   computational fluid dynamics   CT-FFR   computed tomography angiography–derived fractional flow reserve   DCA   decision curve analysis   DS   diameter stenosis   FFR   fractional flow reserve   ICA   invasive coronary angiography   LAD   left anterior descending artery   ML   machine learning   QCA   quantitative coronary angiography   RCA   right coronary artery  

摘要： AbstractBackgroundArteryFlow Technology (AccuFFRct) is a novel noninvasive method for calculating fractional flow reserve (FFR) from coronary computed tomography angiography (CCTA). The accuracy of AccuFFRct has not been adequately assessed. ObjectivesThis study sought to evaluate the diagnostic performance of AccuFFRct in detecting lesion-specific ischemia. MethodsThis prospective study enrolled 339 patients with 404 vessels. CCTA-derived FFR was calculated using an on-site computational fluid dynamics–based method and compared with invasive FFR. The performance of AccuFFRct was comprehensively analyzed in all lesions and subgroups, including “gray zone” lesions, various lesion classifications, clinical presentations, stenosis severities, and lesion locations. ResultsUsing FFR ≤0.80 as a reference standard, the overall diagnostic accuracy, sensitivity, specificity, positive predictive value, and negative predictive value for AccuFFRct were 90.6% (95% CI: 87.3%-93.3%), 90.9% (95% CI: 85.1%-94.9%), 90.4% (95% CI: 86.1%-93.8%), 85.3% (95% CI: 79.8%-89.5%), and 94.2% (95% CI: 90.8%-96.4%), respectively. Good correlation and agreement were found between the computed AccuFFRct and measured FFR. AccuFFRct showed superior discrimination ability to CCTA (AUC: 0.93 [95% CI: 0.89-0.95] vs 0.77 [95% CI: 0.72-0.81]; P < 0.001) and quantitative coronary angiography (AUC: 0.93 [95% CI: 0.89-0.95] vs 0.89 [95% CI: 0.85-0.92]; P = 0.048) for identifying functionally significant stenosis. Notably, AccuFFRct maintained high diagnostic accuracy across the spectrum of lesion classifications, clinical presentations, stenosis severities, lesion locations, and in the gray zone. Furthermore, in the cohort with ≥70% stenosis, AccuFFRct could significantly reduce the rate of un-necessary invasive tests (33.1% vs 6.6%; P < 0.001). ConclusionsThe study confirms the potential of AccuFFRct as a noninvasive alternative to invasive FFR for detecting ischemia in coronary artery disease and to risk

关键词： Tuberculosis (TB)   Computer-aided detection (CAD)   Deep convolutional neural networks (CNN or DCNN)   Tuberculosis screening   Radiology  

摘要： Tuberculosis (TB) is the leading cause of mortality among infectious diseases globally. Effectively managing TB requires early identification of individuals with TB disease. Resource-constrained settings often lack skilled professionals for interpreting chest X-rays (CXRs) used in TB diagnosis. To address this challenge, we developed "DecXpert" a novel Computer-Aided Detection (CAD) software solution based on deep neural networks for early TB diagnosis from CXRs, aiming to detect subtle abnormalities that may be overlooked by human interpretation alone. This study was conducted on the largest cohort size to date, where the performance of a CAD software (DecXpert version 1.4) was validated against the gold standard molecular diagnostic technique, GeneXpert MTB/RIF, analyzing data from 4363 individuals across 12 primary health care centers and one tertiary hospital in North India. DecXpert demonstrated 88% sensitivity (95% CI 0.85-0.93) and 85% specificity (95% CI 0.82-0.91) for active TB detection. Incorporating demographics, DecXpert achieved an area under the curve of 0.91 (95% CI 0.88-0.94), indicating robust diagnostic performance. Our findings establish DecXpert's potential as an accurate, efficient AI solution for early identification of active TB cases. Deployed as a screening tool in resource-limited settings, DecXpert could enable early identification of individuals with TB disease and facilitate effective TB management where skilled radiological interpretation is limited.

关键词： Fixed prosthodontics   Polyetheretherketone   Zirconia   Fracture strength   Post-core   CAD-CAM  

摘要： Background. . The aim of this study was to compare the fracture strength and fracture modes of post-cores produced with CAD-CAM from modified polyetheretherketone (PEEK) materials with other custom-produced post-cores. Methods. . Sixty human mandibular first premolars with equal root sizes were used. The teeth were divided into six groups (n = 10), and root canal treatment was performed. The teeth were separated from the roots over 2 mm from the cemento-enamel junction. As a result of the decoronation process, a 1 mm wide shoulder line was obtained for all teeth. For the fracture strength test, 10 mm deep post spaces were created on the teeth with a 1.6 mm diameter driller. Post-core groups consisted: everStick (R) (R) glass fiber post-core (Group GF), zirconia post-core (Group Z), metal (Cr-Co) post-core (Group M), PEEK post-core without filler (Group UP), PEEK post-core with 20% TiO2 2 Filler (Group TP), and post-core with 20% ceramic filler (Group CP). Following the application of posts to post spaces, copings were created and cemented on the samples. With the universal tester, a force was applied to the long axis of the tooth with a slope of 135 degrees. degrees . The mean fracture strength (N) between the groups was statistically evaluated using one-way ANOVA, and pairwise mean differences were detected using post hoc Tukey's HSD test among the groups. Results. . According to the results of the statistical analysis, a significant difference was found between the groups in terms of mean fracture resistance (p p < 0.05). Group Z (409.34 +/- 45.72) was significantly higher than Group UP (286.64 +/- 37.79), CP (298.00 +/- 72.30), and TP (280.08 +/- 67.83). Group M (376.17 +/- 73.28) was significantly higher than Group UP (286.64 +/- 37.79) and Group TP (280.08 +/- 67.83). There were no statistically significant differences between the means of the other groups (p p > 0.05). Among all the groups, Group Z exhibited a higher prevalence of repairable failure modes, whi

关键词： blunt chest trauma by ice hockey puck   commotio cordis   coronary artery dissection   silent coronary artery disease   sudden cardiac death/arrest during sports   AED   automated external defibrillator   CAD   coronary artery disease   ECG   electrocardiogram   LAD   left anterior descending artery   SCA   sudden cardiac arrest   SCD   sudden cardiac death   TTE   transthoracic echocardiogram   VF   ventricular fibrillation  

摘要： AbstractA 54-year-old hockey player survived sudden cardiac arrest after a chest slapshot, receiving immediate resuscitation and defibrillation of ventricular fibrillation. Examinations revealed chest trauma and subclinical single-vessel disease; a coronary dissection could not be ruled out. The patient recovered without complications, underscoring the importance of rescue equipment in sports facilities.

关键词： CAD-CAM   ceramic   flexural strength   X-ray diffraction  

摘要： PurposeTo analyze the microstructural and mechanical properties of various commercial trademarks of lithium disilicate ceramics for CAD-CAM *** and MethodsSpecimens of different lithium disilicate ceramics were obtained and randomized into 5 groups (n = 14): EM: *** CAD;RT: Rosetta SM;EV: Evolith;PM: Smile-Lithium CAD;and, HS: HaHaSmile. The microstructural analysis was performed by X-ray diffraction (XRD) and scanning electron microscopy (SEM);for flexural strength, the three-point bending flexure test was used. XRD and SEM data were qualitatively evaluated. Data from flexural strength were assessed with one-way ANOVA test (alpha = 0.05) and Weibull *** peaks corresponding to the lithium metasilicate and lithium disilicate pattern with similar intensities were observed in all ceramics in the XRD analysis. SEM images showed similar patterns of crystalline structure in the EM and RT ceramics, while the other three groups presented different crystal morphologies than the previous ones and were similar to each other. No differences were found in flexural strength among the groups (p = 0.28).ConclusionsThe CAD-CAM lithium disilicate ceramics showed comparable crystalline intensities. The microstructure of the EM and RT ceramics were different from the other groups. Flexural strength was similar among all ceramics.

关键词： cardiac magnetic resonance   coronary vasculitis   granulomatosis with polyangiitis   ANA   antinuclear antibody   ANCA   antineutrophil cytoplasmic antibody   CAD   coronary artery disease   CTA   computed tomography angiography   ECG   electrocardiography   ECV   extracellular volume   GPA   LGE   late gadolinium enhancement   STEMI   ST-segment elevation myocardial infarction   TTE   transthoracic echocardiography  

摘要： AbstractGranulomatosis with polyangiitis (GPA) is a rare type of small to medium vessel necrotizing vasculitis that usually affects vessels of the upper or lower airways and kidneys. Cardiac involvement in GPA is often subclinical and if clinically significant has been rarely reported, even less so as an initial presentation. We describe the case of a 44-year-old man who presented with what appeared to be inferior ST-segment elevation myocardial infarction and was found to have small vessel vasculitis of the coronary arteries with associated myocarditis as a presenting manifestation of GPA, which was ultimately treated with steroids, rituximab, and avacopan.

关键词： aortic stenosis   commissural alignment   coronary access   Evolut FX   transcatheter aortic valve implantation   AS   AV   aortic valve   CA   coronary angiogram   CAD   coronary artery disease   CT   computed tomography   LAO   left anterior oblique   TAVI   TAVR   transcatheter aortic valve replacement   THV   transcatheter heart valve  

摘要： AbstractWe present one of the inaugural transcatheter aortic valve implantation procedures using the latest Medtronic platform, Evolut FX+. Successful coronary angiography was achieved within 28 seconds and 1 minute 49 seconds for the left and right coronary arteries, respectively. Postoperative cardiac computed tomography scan demonstrated optimal commissural and diamond-coronary alignment.

关键词： nNOS   CaM   CaMBD   interference peptides   molecular dynamics  

摘要： Introduction The neuronal nitric oxide synthase (nNOS) subtype of nitric oxide synthase (NOS) is an enzyme required for learning and memory. Overactivation of nNOS can lead to oxidative/nitrite stress, which is complicit in the pathophysiology of various neurological and psychiatric disorders. Previous studies have shown that calmodulin (CaM) forms complexes with Ca2+ and binds to the calmodulin-binding domain (CaMBD) of nNOS, thereby upregulating its catalytic activity in hippocampal neurons. To date, there has been no explanation for the non-covalent interactions in the CaMBD-CaM binding structure model of *** In this study, we aimed to investigate the intrinsic factors involved in the binding of CaM to NOS-CaMBD and designed interfering peptides based on the N0 peptide structure of the original nNOS-CaMBD sequence: N1 (obtained from the L734F mutation), N2 (obtained from the F731Y and F740Y mutations), and N3 (obtained from the F731L, V738L, and F740L mutations). We employed homology modeling to construct six CaM-peptide complex models, aiming to elucidate the roles of key amino acid residues within the N0 peptide in its interaction with CaM by means of molecular dynamics simulations. The effect of the peptides on the activation and release of NO by nNOS in neurons was assessed using murine primary neuronal *** When measuring neuronal NO content, it was found that adding N2 and N3 to cultivated neurons significantly increased nNOS activity, leading to the increased NO production. We found that interfering peptides could stably bind to CaM. Among them, N2 and CaM exhibited the strongest binding ability, indicating that the polarized benzene ring significantly enhanced the binding between nNOS-CaMBD and CaM. Conversely, the binding ability between N0 and CaM was the weakest, as they exhibited the worst polar contact, weakest hydrogen bonding, and the lowest binding free energy. The simulation results also highlighted several important amino acid