bluuebunny/crossref_metadata_2025_split huggingface dataset:
The effect of ostrich acellular dermal matrix on keratinized gingival width
Authors: Ahmadi Roya Shariatmadar , Inanlou Mahdi , Khoshzaban Ahad , Asghari Ahmad , Akhondi Nasrin , Sayar Ferena 
Published: October 2023

Background:
Xenogeneic grafts have gained attention due to advantages in compare of autografts. This study aimed to compare Xeno (ostrich) Acellular Dermal Matrix (XADM) with the free gingival graft (FGG) to increase the width of Keratinized gingiva (KGW) in dogs.

Materials and Methods:
This split mouth animal study was performed on 10 mixed breed dogs. The upper second premolar sites were randomly selected for grafting by XADM (test) or FGG (control). Measurements of KGW were recorded before surgery, 1, 3, and 6 months after surgery. Biopsies from grafted sites for histologic and histomorphometric evaluations were harvested 6 months after surgery. Data were analyzed by repeated measured, paired samples t-test, and Wilcoxon Signed rank test. P < 0.05 was considered statistically significant.

Results:
KGW increased in the two study groups after surgery with no significant statistical difference between them at any time intervals (P > 0.05). The graft shrinkage was 23% and 21% for the test and control groups, respectively, without statistically significant difference (P > 0.05). Histomorphometric evaluation showed no significant difference between the two study groups. Foreign body reaction was not seen in any of the study groups.

Conclusion:
Increased KWG was similar between the two study groups. With regard to FGG limitations, XADM may be assumed as a suitable alternative for FGG. It should be noted that this research was an animal study and clinical trials on human should be performed to approve the efficacy and safety of this material.
Evaluation of the antimicrobial efficacy of different concentrations of a novel root canal filling material for primary teeth - An in vitro study
Authors: Govindaraju Lavanya , Jeevanandan Ganesh 
Published: October 2023

Background:
The demand for an ideal root canal filling material in primary teeth with maximum antibacterial properties keeps escalating to improve the success rate of root canal treatment in primary teeth. Hence, the present study was conducted to determine the antimicrobial efficacy of the different concentrations of a novel root canal filling material.

Materials and Methods:
An in vitro study was designed to compare the antimicrobial efficacy of different concentrations of the novel obturating material for primary teeth. Different concentrations of the novel obturating material were prepared using calcium hydroxide, zinc oxide cement, and metronidazole and were tested for its antimicrobial efficacy against Streptococcus mutans and Enterococcus faecalis using Mueller–Hinton Agar for 24 h at 37°C. The zone of inhibition was measured in millimeters after 24 h. The values were entered into a Microsoft Excel spreadsheet and subjected to statistical analysis. Descriptive statistics were used for data summarization and presentation. Friedman test and Kruskal–Wallis test were used to compare the different concentrations of the novel obturating materials against S. mutans and E. faecalis. P < 0.05 was considered to be significant.

Results:
Against S. mutans at 1% concentration, the zone of inhibition was statistically greater at 50 μl and at 2% and 3%, the zone of inhibition was greater at 100 μl. Similarly, against E. faecalis, the zone of inhibition was statistically greater at 100 μl at 2% and no significant difference was noted at 1% and 3%. Comparison between the groups at 25, 50, and 100 μl shows no significant difference against S. mutans between 1%, 2%, and 3% of 60–40 concentration. However, 3% 60–40 concentration at 50 μl shows significantly increased zone of inhibition against E. faecalis.

Conclusion:
Two percentage metronidazole at 60–40 (calcium hydroxide–zinc oxide) concentration of the novel obturating material at 100 μl has better antibacterial properties against both S. mutans and E. faecalis.
Antibacterial activity and shear bond strength of fiber-reinforced composites and bonding agents containing 0.5%, 1%, 2.5%, and 5% silver nanoparticles
Authors: Jenabi Nastaran , Sadeghian Susan , Karimzadeh Fathallah , Pour Maryam S , Rakhshan Vahid 
Published: October 2023

Background:
Bonded composites may increase bacterial accumulation and caries formation risk. Therefore, assessment of methods to decrease bacterial activity around them would be valuable. The literature on the efficacy of adding silver nanoparticles to fiber-reinforced composite (FRC) or adding them to bonding agents in terms of their antibacterial activity and/or shear bond strength (SBS) is scarce. Thus, we aimed to assess the antibacterial activity of flowable composites and bonding agents containing various percentages of experimental silver nanoparticles (nanosilver) against S. mutans and to evaluate the SBS of FRC and bonding agents containing different amounts of nanosilver to enamel.

Materials and Methods:
In this preliminary study, 0% (control), 0.5%, 1%, 2.5%, and 5% nanosilver were added to flowable composite and bonding agent. Syntheses of nanosilver and nanosilver-incorporated composite specimens were approved using X-ray diffraction spectroscopy and scanning electron microscopy. Antibacterial effects of the produced materials on S. mutans were evaluated by colony count with serial dilution method (n = 7 groups × 10 [n = 70] specimens) and agar disc diffusion test (n = 6 groups × 5 [n = 30] composite specimens + n = 6 groups × 5 [n = 30] light-cured bonding + n = 6 groups × 5 [n = 30] uncured bonding) against negative control and cefotaxime antibiotic. Moreover, SBS values of various FRC blocks bonded to enamel using various bonding agents were measured (n = 9 groups × 6 [n = 54] human premolars). Data were analyzed using Kruskal–Wallis, Dunn, two-way analysis of variance, and Tukey's tests (α = 0.05).

Results:
Composite discs containing all concentrations of nanosilver reduced S. mutans colony counts (P < 0.05); bacterial growth was ceased at samples containing 2.5% and 5% of nanosilver. The reduction in the SBS of FRCs was significant only for 5% nanosilver (P < 0.05).

Conclusion:
Adding 0.5%, 1%, and 2.5% nanosilver to composite and 0.5% or 1% nanosilver to bonding agent led to a significant antibacterial behavior against S. mutans while not significantly affecting the SBS of FRC.
The advantages of inhalational sedation using an anesthetic-conserving device versus intravenous sedatives in an intensive care unit setting: A systematic review
Authors: Aseri Zohair Al , Alansari Mariam Ali , Al-Shami Sara Ali , Alaskar Bayan , Aljumaiah Dhuha , Elhazmi Alyaa 
Published: October 2023

Abstract:

BACKGROUND:
Sedation is fundamental to the management of patients in the intensive care unit (ICU). Its indications in the ICU are vast, including the facilitating of mechanical ventilation, permitting invasive procedures, and managing anxiety and agitation. Inhaled sedation with halogenated agents, such as isoflurane or sevoflurane, is now feasible in ICU patients using dedicated devices/systems. Its use may reduce adverse events and improve ICU outcomes compared to conventional intravenous (IV) sedation in the ICU. This review examined the effectiveness of inhalational sedation using the anesthetic conserving device (ACD) compared to standard IV sedation for adult patients in ICU and highlights the technical aspects of its functioning.

METHODS:
We searched the PubMed, Cochrane Central Register of Controlled Trials, The Cochrane Library, MEDLINE, Web of Science, and Sage Journals databases using the terms “anesthetic conserving device,” “Anaconda,” “sedation” and “intensive care unit” in randomized clinical studies that were performed between 2012 and 2022 and compared volatile sedation using an ACD with IV sedation in terms of time to extubation, duration of mechanical ventilation, and lengths of ICU and hospital stay.

RESULTS:
Nine trials were included. Volatile sedation (sevoflurane or isoflurane) administered through an ACD shortened the awakening time compared to IV sedation (midazolam or propofol).

CONCLUSION:
Compared to IV sedation, volatile sedation administered through an ACD in the ICU shortened the awakening and extubation times, ICU length of stay, and duration of mechanical ventilation. More clinical trials that assess additional clinical outcomes on a large scale are needed.
Fluctuations in Seminal Quality throughout the Year: How do Temperature, Humidity and Atmospheric Pressure Impact on Human Sperm Quality?
Authors: Ramírez Nicolás David , Tissera Andrea , Molina Rosa , Olmedo Jose , Molina Héctor Guillermo , Mangeaud Arnaldo , Martini Ana Carolina 
Published: October 2023

Background:
Most studies evaluating the possible seasonal variation of semen quality have considered temperature as the only causal factor.

Aims:
To assess possible seasonality in sperm quality and associations between semen parameters and several meteorological variables (temperature, humidity, apparent temperature and atmospheric pressure) in a large cohort of andrological patients.

Settings and Design:
This was a retrospective, cross-sectional and correlational/descriptive study.

Materials and Methods:
Patients (n: 15665) were categorised into four groups (summer, winter, spring and autumn) according to the date of assistance at the fertility centre. Daily values of temperature, apparent temperature, humidity and atmospheric pressure were provided by the National Weather System and were calculated as the average of the 74 days previous to semen collection (spermatogenic cycle).

Statistical Analysis Used:
As appropriate, the results were analysed by analysis of variance/Kruskal–Wallis, Chi-square test, t-test/Mann–Whitney, forward conditional regression model and Spearman/Pearson’s correlations.

Results:
We detected seasonality effects on sperm count, total sperm count and total motile sperm count, with the highest values in winter and the lowest in summer. Correlation analysis showed that temperature, apparent temperature and humidity negatively correlated with semen parameters, being humidity the most powerful predictive meteorological variable.

Conclusion:
Sperm quality is influenced by seasons; increased environmental temperature and humidity negatively affect semen quality.
Ovarian Stimulation in Patient-oriented Strategies Encompassing Individualised Oocyte Number-4 Category; Antagonist versus Short-agonist Protocols
Authors: Al-Hussaini Tarek K. , Mohamed Ahmed Aboelfadle , Askar Ayman , Abden Ahmed A. , Othman Yousra M. , Hussein Reda S. 
Published: October 2023

Background:
Recently POSEIDON (Patient-Oriented Strategies Encompassing Individualized Oocyte Number) classification was proposed to categorize patients with expected poor response to conventional stimulation. Searching for the ideal management of poor responders in IVF is still an active research area.

Aims:
This study compares GnRH-antagonist and GnRH-agonist short protocols in ICSI cycles for the POSEIDON-4 group.

Settings and Design:
This retrospective study was conducted in a tertiary infertility unit between January 2016 and December 2020.

Materials and Methods:
Infertile women who met the criteria for POSEIDON 4 group and underwent fresh ICSI-ET in using GnRH-antagonist and GnRH-agonist short protocols was performed. POSEIDON-4 includes patients ≥ 35 years with poor ovarian reserve markers; AFC < 5 and AMH < 1.2 ng/ml.

Statistical Analysis Used:
Numerical variables were compared between both groups by student’s t test and Mann Whitney test when appropriate. Chi-square test used to compare categorical variables. Multivariate logistic regression models were utilized to adjust for the effect of the different study confounders on live birth rate.

Results:
One hundred ninety fresh ICSI cycles were analyzed. Of the total cohort, 41.6 % (79) patients pursued antagonist protocol compared to 58.4% (111) underwent short agonist protocol. Fresh embryo transfer was accomplished in 55.7 % (44/79) vs. 61.3 % (68/111), P = 0.44 in antagonist vs. short protocol respectively. Cycle cancellation due to poor ovarian response was encountered in (32.9%vs. 27.9%, P = 0.50) in the antagonist and short groups, whereas no good-quality embryos were developed after ovum pickup in 11.4% vs. 10.8%, P>0.05. Comparable total gonadotropins dose, number of retrieved and mature oocytes, and good-quality embryos were found in both groups. Likewise, clinical pregnancy rate was not different for the antagonist and short groups [11/79 (13.9%) vs. 20/111 (18%), P = 0.45]. The live birth rate was comparable between both groups (8.9% vs. 10.8%, P = 0.659) for antagonist and short groups respectively. No significant impact for the protocol type on live birth rate was revealed after adjusting to cycle confounders in multivariate analysis (OR: 0.439, 95%CI 0.134-1.434, P = 0.173).

Conclusion:
This study shows comparable pregnancy outcomes for antagonist and short-agonist protocols in IVF/ICSI cycles for POSEIDON-4 category.
Acceptance of Elective Single-embryo Transfer in a Resource-limited Setting: A Cross-sectional Questionnaire-based Study
Authors: Jayakumar Nithya Panapakkam , Solanki Megha , Karuppusami Reka , Joseph Treasa , Aleyamma Thayparmbil Kunjummen , Kamath Mohan Shashikant 
Published: October 2023

Background:
While elective single-embryo transfer (eSET) has been advocated in select countries, the global acceptance of the eSET policy has been undermined due to various issues. It is imperative to understand the couples’ perspectives regarding the number of embryos transferred.

Aims:
We planned a study to evaluate the knowledge and attitude of infertile couples undergoing assisted reproductive technology towards eSET in self-funded treatment cycles in a low-resource setting.

Settings and Design:
We conducted a cross-sectional study at a tertiary-level referral facility between February 2020 and September 2022.

Materials and Methods:
This was an interviewer-administered questionnaire-based survey in two stages. The first stage involved the assessment of the knowledge of the participants. Following this, participants were given an information pamphlet and the second stage of the interview was conducted to assess the attitude and change in preference for embryo transfer number.

Statistical Analysis Used:
The Chi-square and Fisher’s exact test were applied to find an association between categorical variables. Logistic regression was used to assess the association between factors and outcomes.

Results:
eSET was the preferred choice for only 5.8% of the participants. Following our educational intervention using an information leaflet, there was a statistically significant increase in the preference for eSET (P = 0.01). Univariate logistic regression analysis revealed that participants with a monthly income of ≤50,000 INR had a significantly higher preference for eSET.

Conclusion:
Continued emphasis on the risks of double-embryo transfer coupled with individualised selection criteria for eSET may help to achieve reasonable congruency between the clinician and couples’ decision.
Optimal Embryo Selection: The Irreplaceable Role of the Embryologist in an Age of Advancing Technology
Authors: Rauchfuss Lauren Kendall , Zhao Yulian , Walker David , Galantis Terri , Fredrickson Jolene , Barud Kathrynne , Shenoy Chandra 
Published: October 2023

Background:
Time-lapse incubators allow for ongoing evaluation of embryos without culture condition disruption. The use of time-lapse incubation has been shown to improve outcomes either by improving overall conditions or providing additional information to aid in embryo selection for transfer. Time-lapse incubators can also utilise morphokinetic models to rank embryos based on morphokinetic parameters. We sought to compare a morphokinetic model for embryo comparison to traditional morphologic evaluation.

Aims:
The aim of the study is to compare a morphokinetic model for embryo comparison to traditional morphologic evaluation.

Settings and Design:
This is a retrospective cohort design.

Materials and Methods:
Embryos cultured in a time-lapse culture system that had traditional morphologic evaluation, morphokinetic modelling and known live birth outcomes were included in this study. Embryos with unknown competence were excluded, including when two embryos were transferred with a single live birth resulted.

Statistical Analysis Used:
Receiver operating characteristic (ROC) curves were determined for both the morphologic analysis and the morphokinetic model on culture day 3 and day 5. Using the ROC-determined cutoff that optimised both sensitivity and specificity, a binary outcome for each test was analysed using agreement statistics to determine if one method of embryo evaluation was superior to the other.

Results:
Morphological and morphokinetic grading were both predictive of embryo competence on days 3 and 5. However, on day 3, morphologic grading was superior to morphokinetic grading with area under the curve (AUC) of 0.66 (P < 0.001) and 0.58 (P = 0.009), respectively. Contrarily, on day 5, the morphokinetic model had a higher AUC of 0.65 (P = 0.03) compared to the morphologic grading, AUC 0.56 (P = 0.02).

Conclusion:
Traditional morphology was noted to be a better diagnostic tool (higher AUC) on culture day 3 while a morphokinetic model was superior on day 5.
Comparison of surface topography of low-friction and conventional TMA orthodontic arch wires using atomic force microscopy
Authors: Alsabti Nouf I. , Bourauel Christoph P. , Talic Nabeel F. 
Published: October 2023

OBJECTIVE:
To evaluate the surface topography and roughness of orthodontic arch wire materials, including low-friction titanium molybdenum alloy (TMA), conventional TMA, and stainless-steel arch wires.

MATERIALS AND METHODS:
The surface topography was evaluated using atomic force microscopy (AFM). A total of 24 wire specimens were used for the AFM scans {8 low-friction TMA (TMA-Low), 8 conventional TMA (TMA-C), and 8 stainless steel (SS)} (Ormco, Orange, CA, USA), measuring 0.016 × 0.022 inches. The conventional and low-friction TMA arch wires served as the test groups, while the stainless-steel arch wire served as the control group.

RESULTS:
Surface roughness evaluation using AFM revealed that the highest mean of all three roughness parameters was found in the TMA-C group followed by the TMA-Low and SS arch wires in descending order. Pairwise comparison of the mean values showed that the mean value of the SS arch wire material is statistically significantly lower than the mean values of the other two arch wire materials (TMA-C and TMA-Low). However, there was no statistically significant difference in the mean values of TMA-C and TMA-Low arch wires.

CONCLUSION:
The SS arch wire showed the smoothest surface topography among the alloys and had statistically significantly lower roughness values than the TMA-C and TMA-Low groups. Low-friction TMA arch wire is still considered to be inferior to stainless steel arch wire.
PREGNANCY OUTCOME IN WOMEN WITH GRAVES’ DISEASE
Authors: Nabi Tauseef , Rafiq Nadeema 
Published: October 2023

Background and Aims:
Pregnancy complicated with poorly controlled thyrotoxicosis is associated with an increased risk of adverse pregnancy outcomes, and maternal complications. To study the clinical characteristics, feto-maternal outcomes in women with Graves’ disease (GD) during pregnancy.

Methods:
This was observational study on 98 patients with GD during pregnancy at the tertiary care hospital. GD was documented by Thyrotropin receptor antibody (TRAb). Patients were subjected to complete clinical work up and thyroid profile. The diagnosis of TAO was based on the criteria of Bartley and Gorman. 100 pregnant women with normal thyroid function were taken as control. Birth outcomes recorded were: route of delivery (vaginal or cesarean section), neonatal birth weight, spontaneous abortion, stillbirth, and small for gestational age (SGA). Maternal outcomes accessed were: gestational hypertension, gestational diabetes (GDM), preeclampsia, gestational age at delivery, preterm delivery, antepartum hemorrhage, and postpartum hemorrhage.

Results:
The mean age of the patients was 30.8±7.6 years as compared to 32.9±6.8 years in controls. Compared with the controls; the pregnant women with GD had significantly higher rates of small for gestational age (SGA) (23.5% vs. 12.0%; p: 0.034), preterm birth (22.4% vs. 12.0%; p: 0.049), preeclampsia (15.3% vs. 5.0%; p: 0.016) and cesarean section (82.7% vs.70.0%; p: 0.036). Maternal and neonatal outcomes in pregnant women with GD with controlled and uncontrolled thyrotoxicosis were not significantly different except for birth weight.

Conclusion:
GD was significantly associated with an increased risk of adverse pregnancy outcomes.
COMPUTER VISION AND MACHINE LEARNING FOR ASSESSING THYROID NODULE COMPOSITION: ADVANCING TOWARDS ML-THYROID IMAGING REPORTING AND DATA SYSTEM DEVELOPMENT
Authors: Lakhani Om J , Shah Shalin , Raiththa Pratik 
Published: October 2023

Background:
Our study aims to develop a new algorithm that utilizes computer vision to accurately assess the composition of thyroid nodules and calculate the Thyroid Imaging Reporting & Data System (TIRADS) score based on uploaded nodule images. This prospective observational study evaluates the performance of our computer vision model in correctly classifying the composition of thyroid nodules.

Methods:
We developed a computer vision and machine learning model using the nocode AI tool “Levity” to accurately classify the composition of thyroid nodules as “Solid”, “Cystic”, “Mixed solid-cystic”, or “Spongiform”. The model was trained on 200 thyroid nodule images, labeled by an experienced endocrinologist. We tested the model on 50 additional images using an easy-to-use chatbot tool and assessed the clinician’s agreement with the diagnosis. The tool can be accessed for public use using the following link: https://tinyurl.com/2pfehpq8. Statistical analysis using the Chi-square test, Pearson correlation coefficient and point-biserial correlation coefficient was performed using Python and R. p value of less than 0.05 was considered as statistically significant.

Results:
The computer model diagnosed 50 test images, with 34 solid, 5 mixed solid-cystic, 7 purely cystic, and 4 spongiform. Clinician agreement was 64% and partial agreement was 20%, resulting in 84% total agreement. Chi-squared test showed a statistically significant relationship between model diagnosis and clinician agreement (p value of 0.0000059403). Pearson’s correlation test showed a statistically significant correlation between the percentage confidence of the model and clinician agreement (p value of 0.034). The model was confident in 56% of cases, with 60.7% confidence when the clinician agreed and 57.9% for partial agreement. Using the point-biserial correlation, a statistically significant correlation was found between the percentage value given by the model and agreement of the clinician (p value of 0.00182). Using the ROC curve, an optimal cutoff of 52.28% was determined for rejecting the model diagnosis. AUC was 0.85, indicating good performance.

Conclusions:
In conclusion, our study successfully developed a computer vision and machine learning model using Levity to accurately classify thyroid nodule composition. Our model showed good performance with statistically significant results in clinician agreement, Chi-squared test, Pearson’s correlation test, and point-biserial correlation. The tool can be accessed for public use, and an optimal cutoff of 52.28% was determined for rejecting the model diagnosis.