Complete-arch accuracy of seven intraoral scanners measured by the virtual-fit method.

OBJECTIVES: This study compared the accuracy of seven intraoral scanners (IOS) by the virtual-fit method. METHODS: Four maxillary arches with tooth abutments were scanned with an industrial reference scanner (n=1) and by Aoralscan3, EmeraldS, Helios600, Lumina, Mediti700, Primescan, and Trios5 IOSs (each n=12). Two complete-arch fixed frameworks were designed on each IOS scan with a 70 µm (group 70) and a 90 µm internal cement space (group 70+20, additional 20 µm at the margin). The virtual-fit method was comprised of superimposing the framework designs onto the reference scan using a non-penetrating algorithm simulating the clinical try-in. Internal and marginal gaps were measured. Precision was estimated by the mean absolute errors (MAE). RESULTS: In group 70, Mediti700 (43 µm), Primescan (42 µm), and EmeraldS were in the best homogenous subset for the marginal gap, followed by the Lumina (67 µm), Aoralscan3 (70 µm), and Trios5 (70 µm), whereas Helios600 (118 µm) was in the third subset. Based on the MAE at the margin, Mediti700, Trios5, and EmeraldS were in the first-best homogenous subset, followed by Primescan. Lumina and Helios600 were in the third subset, and Aoralscan3 was in the fourth subset. In group 70+20, the marginal gap was significantly decreased for Lumina and Aoralscan3, whereas MAE significantly decreased for EmeraldS and Aoralscan3. The rank of IOSs was similar for the internal gap. CONCLUSION: EmeraldS, Mediti700, Primescan, and Trios5 meet the marginal and internal fit criteria for fixed tooth-borne complete arch restorations. Increasing the cement space during design could enhance restoration fit. CLINICAL SIGNIFICANCE: The virtual-fit alignment method can effectively evaluate the accuracy of different intraoral scanners, offering valuable clinical guidance for distinguishing among them. Recent software and hardware versions of long-standing IOS manufacturers are suitable for fabricating complete arch restoration.

Post sterilization of intraoral scan body and the effect it has on the axes and distances between three adjacent implants: in-vitro study.

BACKGROUND: The purpose of this pilot in-vitro study was to assess the effect of sterilization on the intra-implant axis, inter-implant axis, intra-implant distance and inter-implant distance of three implants in a straight line by using laboratory scanner (LBS) versus intra-oral scanner (IOS) with intra-oral scan bodies (ISB). METHODS: A printed 3D model with three internal hex analogs in the positions 15#,16#,17# was used. Zirkonzhan (ZZ) intra-oral scan body (ISB), two-piece titanium was used. The ZZ ISBs were scanned by 7 Series dental wings (LBS) and 30 times by Primescan (IOS) pre sterilization and 30 times post sterilization. For each scan (pre and post) stereolithography (STL) file was created and a comparison between all the scans pre sterilization and post sterilization were superimposed on the laboratory scan by using a 3D analyzing software. A Kolmogorov-Smirnov test performed followed by Wilcoxon Signed Ranks tests. (p < 0.05) Results: Post sterilization of the ZZ ISB, the mean errors were significantly increased for the inter-implant distances (p < 0.0005), intra-implant distances 1,2,3 (p < 0.0005), intra-implant axis 1,3 (p < 0.0005) and inter-implant axes 13,23 (p < 0.05). In contrast, the mean errors for intra-implant axis 2 (p < 0.0005) and inter-implant axis 12 (p < 0.0005) were significantly reduced. CONCLUSIONS: ZZ ISB showed changes in all four parameters after sterilization. The middle ISB had the largest changes in mean error regarding all four parameters. Sterilization process may affect the three-dimensional (3D) structure of the ZZ ISB after three cycles. There is a lack in the literature in this field and there is a need for further studies to explore the effect of sterilization (multiple cycles) on different ISBs and for creating an approved guidelines regarding the amount of sterilization for each ISB in the industry.

Oenothein B from Eugenia uniflora leaves exerts pro-angiogenic effects by increasing VEGF and TNF-α levels.

Oenothein B (OeB), a dimeric ellagitannin with a macrocyclic structure, is reported to have beneficial effects, including antioxidant, antitumor, antiviral, and antimutagenic effects, on human health. Despite the remarkable properties of OeB, its role in neovascularization process has not yet been evaluated. Thus, this study aimed to evaluate the angiogenic activity of OeB using a chorioallantoic membrane (CAM) assay at different concentrations (6.25, 12.5, and 25 µg/µL), employing digital imaging and histological analysis. Furthermore, to elucidate the mechanisms by which OeB influences angiogenesis, we assessed the levels of vascular endothelial growth factor (VEGF) and tumor necrosis factor-alpha (TNF-α) in CAM using immunohistochemical analysis. All concentrations of OeB significantly increased (p < 0.05) the percentage of vascularization as well as the levels of all the angiogenesis-associated parameters evaluated, indicating the pronounced pro-angiogenic activity of OeB. Our results showed that inflammation was one of the most relevant phenomena observed in CAM histology along with angiogenesis. In addition, a significant increase in VEGF and TNF-α levels was observed in all the CAMs compared to the negative control (p < 0.05). We suggest that OeB may induce the presence of inflammatory cells in CAM, leading to increased VEGF and TNF-α levels that result in the induction of angiogenesis. Therefore, OeB presents a favorable profile that could be further explored for the development of drugs for pro-angiogenic and tissue repair therapies.

Clinical and Histological Efficacy of Digitally Designed CAD CAM Allogenic Bone Blocks. A Prospective Cohort.

The growth in bone reconstructive surgery has been unsurpassed in recent decades. However, most bone regenerative products lack any potential for delivering site-specific morphologically driven augmentation. It was therefore the purpose of this study to evaluate the histological and clinical incorporation of a novel CAD CAM allogenic block bone graft for the reconstruction of complex 3- dimensional alveolar defects. In addition the clinical outcome of dental implants subsequently placed and loaded within these grafts was assessed with up to 5 years in function. Results demonstrated that 4 of the initial 17 blocks failed (23.5%). The remaining 13 blocks plus an additional two replacement blocks were fully or partially incorporated within the recipient bone site (79%). Of the 29 implants placed within the integrated blocks, no failures occurred with up to 5 years in function, with a recorded mean marginal bone loss by implant of -0.5mm.

In Vivo Xenograft Model to Study Tumor Dormancy, Tumor Cell Dissemination and Metastasis.

Metastasis is a complex, multistep process. To study the molecular steps of the metastatic cascade, it is important to use an in vivo system that recapitulates the complex tumor microenvironment. The chicken embryo chorioallantoic membrane (CAM) is an in vivo system suitable for the implantation of xenograft tumor models. It allows the study of different aspects of the metastatic process, including the dormancy-awakening transition. The main advantages of this system are its high reproducibility, cost-effectiveness, and versatility. Here, by using two dormancy tumor models, one of head and neck squamous cell carcinoma and one of breast cancer, we described a detailed protocol for the use of the CAM model in metastasis assays and for the study of tumor growth and dormancy.

Revolutionizing CAD/CAM-based restorative dental processes and materials with artificial intelligence: a concise narrative review.

Artificial intelligence (AI) is increasingly prevalent in biomedical and industrial development, capturing the interest of dental professionals and patients. Its potential to improve the accuracy and speed of dental procedures is set to revolutionize dental care. The use of AI in computer-aided design/computer-aided manufacturing (CAD/CAM) within the restorative dental and material science fields offers numerous benefits, providing a new dimension to these practices. This study aims to provide a concise overview of the implementation of AI-powered technologies in CAD/CAM restorative dental procedures and materials. A comprehensive literature search was conducted using keywords from 2000 to 2023 to obtain pertinent information. This method was implemented to guarantee a thorough investigation of the subject matter. Keywords included; "Artificial Intelligence", "Machine Learning", "Neural Networks", "Virtual Reality", "Digital Dentistry", "CAD/CAM", and "Restorative Dentistry". Artificial intelligence in digital restorative dentistry has proven to be highly beneficial in various dental CAD/CAM applications. It helps in automating and incorporating esthetic factors, occlusal schemes, and previous practitioners' CAD choices in fabricating dental restorations. AI can also predict the debonding risk of CAD/CAM restorations and the compositional effects on the mechanical properties of its materials. Continuous enhancements are being made to overcome its limitations and open new possibilities for future developments in this field.

Accuracy of lingual fixed retainers fabricated using a CAD/CAM bending machine.

Objective: Lingual fixed retainers, made from 0.0175-inch 3-strand twisted stainless steel wire (TW) and 0.016 × 0.022-inch straight rectangular wire (RW), are generally used in clinical practice. This study aimed to calculate their accuracy by comparing the discrepancy between computer-aided customized retainers made from these two types of wires. Methods: Eleven orthodontic patients were selected, resulting in 22 maxillary and mandibular three-dimensional printing dental models. Two types of lingual fixed retainers were bonded from canine to canine. To determine the accuracy, five points were chosen for each model, resulting in 110 selected points. The absolute values of the distances on the x-, y-, and z-axes were measured to compare the accuracy of the two types of computer-aided retainers. Results: The accuracy of the two types of retainers did not differ significantly in the x- and z-axes, but only in the y-axis (P < 0.01), where RW-fixed retainers exhibited a slightly but significantly increased distance compared to the TW. Conclusions: Both types of retainers showed high accuracy; however, RW had a slight but statistically significant difference along the y-axis compared with TW. This type of computer-aided design/computer-aided manufacturing bending machine is limited to two dimensions, and the dental arch is curved. Therefore, RW may require slight manual adjustment by the practitioner after manufacturing.

Implementation of Patient-Individualized 3D-Printed Models in Undergraduate Students' Education for Various Prosthetic Treatments: A Cross-Sectional Survey Study.

BACKGROUND: Due to rapid changes in dental practice, digital technologies have become prominent in undergraduate dental education at German universities in recent years. This shift has prompted a re-evaluation of content as well as teaching methods, particularly in courses where students are prepared for patient treatment. Traditional training on standardized models with resin teeth cannot cover the complexity of individual dental arch configuration encountered in patient situations. This study explores the use of 3D printing technology to create individualized models for prosthetic treatment simulations, aiming to evaluate students' feedback towards their experience with this training setting. METHODS: First, the study describes the design and fabrication of individualized models with exchangeable teeth based on intraoral scans, mounted on connected plates with distance holders that can be fixed to standard phantom heads. Second, students provided feedback through a questionnaire, assessing various aspects such as the effectiveness of the 3D-printed models compared to traditional frasaco models for preparation exercises. RESULTS: The results indicated that the design of the realized models was feasible for preparation training (question no. 4: 93% positive rating) and showed positive perceptions of the 3D-printed models, with students finding them effective for preparation exercises and beneficial in bridging the gap between simulation and real patient situations (question no. 6: 69% positive rating). CONCLUSIONS: The study suggests that 3D printing technology offers a valuable tool in dental education, providing realistic and patient-specific scenarios for students to enhance their skills and readiness for clinical practice. Further improvements in material properties in hand with cost-effective approaches are essential for widespread implementation.

A Novel Device for the Evaluation of In Vitro Bacterial Colonization in Membranes for Guided Tissue and Bone Regeneration.

Purpose: To evaluate, in vitro, the efficiency of a novel apparatus to test the adherence and penetration of bacteria on different membranes for guided regeneration. Methodology: To create the 3D device, Computer Aided Design/Computer Aided Manufacturing (CAD/CAM) systems were used. Three types of biomaterials were tested (n = 6): (DT) a collagen membrane; (DS) a polymer membrane; and (LP) a dense polytetrafluoroethylene barrier. The biomaterials were adapted to the apparatuses and challenged with two different monospecies bacterial culture of A. actinomycetemcomitans b and S. mutans. After 2 h, bacterial adherence and penetration were quantified by counting the number of colony-forming units (CFUs). Two specimens from each group were used for image analysis using Confocal Laser Scanning Microscopy. Statistical analysis was performed. Findings: The DS group had a higher adherence of S. mutans compared to A. actinomycetemcomitans b (p = 0.05). There was less adherence of A. actinomycetemcomitans b in the DS group, compared to the LP (p = 0.011) and DT (p < 0.001) groups. Only the membranes allowed penetration, which was blocked by barriers. The DT group allowed a greater penetration of S. mutans to occur compared to A. actinomycetemcomitans b (p = 0.009), which showed a higher penetration into the DS membranes compared to S. mutans (p = 0.016). The penetration of A. actinomycetemcomitans b through DS was higher compared to its penetration through DT and LP (p < 0.01 for both). DT and DS allowed a greater penetration of S. mutans to occur compared to LP, which prevented both bacterial species from penetrating. Conclusion: The apparatus allowed for the settlement and complete sealing of the biomaterials, enabling standardization.

Fracture Resistance of Posterior Milled Nanoceramic Crowns after Thermomechanical Aging.

Fracture resistance is an important parameter used to predict the performance of indirect dental restorations. The purpose of this in vitro study was to assess the fracture load of posterior milled nanoceramic crowns, in comparison with the lithium disilicate crowns, after fatigue loading, for two different restoration occlusal thicknesses. Forty test metal dies were fabricated by duplicating a master metal model consisting of an anatomic abutment preparation of the maxillary first premolar for a single crown. The dies were divided into two groups of 20 each for the fabrication of nanoceramic (Lava Ultimate) and lithium disilicate (IPS e.max CAD) single crowns. Each material group was further divided into two sub-groups of 10 dies each, based on crown occlusal thickness, of 0.5-mm and 0.75-mm (n = 10). Dental Type V stone dies poured from polyvinyl siloxane impressions of the test metal dies were laboratory scanned in order to design and mill 40 ceramic crowns. The crowns were cemented on to the test metal dies with a self-adhesive resin luting cement. All crowns were thermocycled (2500 cycles) and mechanically loaded (250,000 cycles) in a chewing simulator followed by static loading until failure, and the values noted. The data were statistically analyzed by 2-way ANOVA and Tukey HSD post-hoc multiple comparison tests (α = 0.05). The mean fracture loads ranged from 1022 to 1322 N for nanoceramic crowns and from 1145 to 1441 N for the lithium disilicate crowns. Two-way ANOVA revealed insignificant differences between the nanoceramic and lithium disilicate crowns (p > 0.05) in terms of fracture load. Significant differences were noted in the fracture resistance of crowns based on occlusal thickness (303 N; p = 0.013) regardless of the material used. Multiple comparisons by Tukey HSD post-hoc test showed insignificant differences between the four material-occlusal thickness groups (p > 0.05). The nanoceramic crowns were found to be comparable with lithium disilicate crowns in terms of fracture load. The mean fracture loads of all of the tested crowns were within the normal physiological masticatory load limits. Based on the fracture-resistance results, nanoceramic crowns seem to be suitable for clinical use for the tested occlusal thicknesses.

Trueness of the apical and middle root portion segments of 3D-printed removable die and alveolar cast designs manufactured using stereolithographic 3D printing.

PURPOSE: The present study evaluated the effects of the root portion design, segment (middle vs. apical), and part (die vs. cast) on the trueness of three-dimensional (3D)-printed removable die-cast complex. MATERIAL AND METHODS: The trueness of apical and middle segments of the root portion of 45 3D-printed removable dies and casts with three different root portion designs (n = 15) was assessed using a metrology-grade computer program. The three removable dies and cast designs (root form [RF], conical [CON], and cylindric [CYL]) were created using professional computer-aided manufacturing computer programs (DentalCAD 3.1 Rijeka, and InLab CAD 22.0), and manufactured using stereolithographic 3D printer (Form3; FormLabs, Somerville, MA). Subsequently, the 3D-printed removable dies and casts were scanned by a single operator with an intraoral scanner (PrimeScan; Dentsply Sirona, Charlotte, NC), and their respective standard tessellation language files were aligned and compared to master reference files in a metrology-grade computer program (Geomagic Control X; 3D systems, Rock Hill, NC). The root mean square (RMS) values of the middle and apical segments for each removable die and cast were calculated and analyzed using a mixed model including a repeated measure 3-way analysis of variance (ANOVA) and post-hoc stepdown Bonferroni-corrected pairwise comparisons (α = 0.05). RESULTS: A statistically significant 3-way interaction between factors was detected, suggesting that the part (removable die or alveolar cast) and their design affected the RMS values of their apical and middle root portion segment. (p = 0.045). The post-hoc analysis identified significant differences between RMS values of the apical segments of the CON and CYL removable dies (p = 0.005). Significant differences were observed between the middle and apical segments of the CON (p < 0.001) and RF removable die designs (p = 0.004). No statistically significant differences were noticed between the RMS of the different alveolar cast designs (p > 0.05). Significant differences were detected between the apical and middle segments of the same alveolar cast design (p < 0.05). CONCLUSIONS: For the manufacturing trinomial and 3D printing strategy used in the present study, the interaction of the part, design, and segment affected the trueness of removable dies and alveolar casts. The trueness was higher on the middle segment on removable dies and alveolar casts in all designs used, except for CYL removable dies, where the trueness difference between segments was small. Higher trueness values may be achieved with designs with simple apical segment geometries.

Fracture resistance of ultratranslucent multilayered zirconia veneers with different facial thicknesses.

To assess the fracture resistance of computer-aided design and computer-aided manufacturing (CAD/CAM) ultratranslucent multilayered zirconia (5Y-YZP) veneers with varying facial thickness. Sixty translucent zirconia veneers were designed and milled using a chairside CAD/CAM system for maxillary central incisors. The butt joint incisal veneer tooth preparations consisted of 1.00 mm incisal reduction, 0.40 mm chamfer margin, and three different facial reductions; 0.50, 0.75, and 1 mm, respectively. The ceramic veneers were cemented to printed resin dies and subjected to thermal cycling. Subsequently, the restorations were loaded with compressive loading force, and fracture occurrences were recorded. Scanning electron microscope (SEM) images of the fractured specimens were captured. The fracture resistance varied among the veneers with different facial thicknesses. Ultratranslucent zirconia veneers with a facial thickness of 1.00 mm exhibited the highest fracture resistance values (742.15 N), followed by those with 0.75 mm facial thickness (673 N). Minimally invasive veneers with 0.50 mm thickness displayed similar fracture resistance as thicker veneers with 0.75 mm. However, veneers with 1.00 mm thickness displayed the highest values. SEM fracture patterns for 0.50 and 0.75 mm display similar and fewer crack lines than 1.00 mm veneers. RESEARCH HIGHLIGHTS: Minimally invasive zirconia veneers exhibit similar fracture resistance to thicker veneers.

Digital impression perception among dental students in Saudi Arabia: A cross-sectional study.

INTRODUCTION: The use of digital dentistry is rapidly increasing in prosthodontics. However, most dental students are not familiar with applying digital technologies in dental clinics. Thus, the aim of the current study was to assess the perception of dental students at different educational years towards digital impressions in comparison to conventional impressions. MATERIALS AND METHODS: A cross-sectional questionnaire-based study was conducted on various educational years of dental students in the College of Dentistry, Imam Abdulrahman Bin Faisal University, between February and April 2023. The students had performed at least one intraoral scan (Trios 3shape) and another conventional polyether impression for phantom casts/patients. The questionnaire assessed students' perceptions of digital impressions using a 5-point scale ranging from strongly agree to strongly disagree. Mann-Whitney U and Kruskal-Wallis tests were used to compare students' perceptions of digital impressions according to gender and educational year, respectively. RESULTS: The study included 122 students. About 55% were females with a mean (SD) age = 22.51 (3.36). Most students thought that digital impressions are faster and more user-friendly compared to conventional impressions. Significantly more female students thought that the handpiece was too big for intraoral use (p = 0.04) and that the process of the software was time-consuming and complicated. In general, higher educational year students were more satisfied with the digital impressions than lower educational year students. CONCLUSIONS: Digital impressions were perceived by most students as being faster and easier than conventional ones. However, male students and those with higher educational years showed better perception of digital impression.

The P2 protein of wheat yellow mosaic virus acts as a viral suppressor of RNA silencing in Nicotiana benthamiana to facilitate virus infection.

Wheat yellow mosaic virus (WYMV) causes severe viral wheat disease in Asia. The WYMV P1 protein encoded by RNA2 has viral suppressor of RNA silencing (VSR) activity to facilitate virus infection, however, VSR activity has not been identified for P2 protein encoded by RNA2. In this study, P2 protein exhibited strong VSR activity in Nicotiana benthamiana at the four-leaf stage, and point mutants P70A and G230A lost VSR activity. Protein P2 interacted with calmodulin (CaM) protein, a gene-silencing associated protein, while point mutants P70A and G230A did not interact with it. Competitive bimolecular fluorescence complementation and competitive co-immunoprecipitation experiments showed that P2 interfered with the interaction between CaM and calmodulin-binding transcription activator 3 (CAMTA3), but the point mutants P70A and G230A could not. Mechanical inoculation of wheat with in vitro transcripts of WYMV infectious cDNA clone further confirmed that VSR-deficient mutants P70A and G230A decreased WYMV infection in wheat plants compared with the wild type. In addition, RNA silencing, temperature, ubiquitination and autophagy had significant effects on accumulation of P2 protein in N. benthamiana leaves. In conclusion, WYMV P2 plays a VSR role in N. benthamiana and promotes virus infection by interfering with calmodulin-related antiviral RNAi defense.

Bonding Efficiency between Artificial Teeth and Denture Base in CAD/CAM and Conventional Complete Removable Dentures.

A common challenge encountered with both traditional and digitally produced dentures involves the extraction of artificial teeth from the denture base. This narrative review seeks to present an updated perspective on the adherence of synthetic teeth for denture base materials, employing diverse methods. Dental technicians often employ chemical approaches and mechanical techniques (including abrasion, laser treatment, and abrasive blasting) to augment the retention of denture teeth. However, the efficacy of these treatments remains uncertain. In certain instances, specific combinations of Denture Base Resin (DBR) materials and artificial teeth exhibit improved performance in conventional heat-cured dentures following these treatments. The primary reasons for failure are attributed to material incompatibility and inadequate copolymerization. As new denture fabrication techniques and materials continue to emerge, further research is imperative to identify optimal tooth-DBR combinations. Notably, 3D-printed tooth-DBR combinations have demonstrated reduced bond strength and less favorable failure patterns, while utilizing milled and traditional combinations appears to be a more prudent choice until advancements in additive manufacturing enhance the reliability of 3D-printing methods.

Determination of the Color Change of Various Esthetic Monolithic Monochromatic Computer-Aided Design/Computer-Aided Manufacturing Materials.

Dental technology has developed materials for prosthetics that are very similar to natural teeth and offer a good balance between durability and esthetics; however, some of these materials are not very color-stable under the influence of external factors. Therefore, the aim of this study is to determine and compare the color change (∆E00) of different esthetic monolithic monochromatic CAD/CAM materials after they have been thermocycled and treated with staining solutions. The color parameters were determined using a spectrophotometer on a white and black background. Five CAD/CAM materials were used for this study-CAD/CAM nanoceramic (GC Cerasmart270), CAD/CAM lithium disilicate ceramic (IPS e.max CAD), CAD/CAM polymer (Telio CAD), CAD/CAM composite (Tetric CAD) and CAD/CAM polymer-infiltrated ceramic (Vita Enamic). The test specimens produced were divided into groups and were thermocycled in distilled water. They were then stored for four weeks at 37 °C in either distilled water as a control liquid, black tea, instant coffee or red wine. The aim is also to evaluate the color changes as a function of the exposure time of the staining solutions. The results obtained were analyzed statistically. All CAD/CAM materials tend to discolor to varying degrees. Among the factors contributing to discoloration, red wine proved to be the most significant influencing factor. The conclusion from the results is that the color change is influenced by the type of material, the staining solution, the sample thickness, the color background and the aging time.

Diagnostic Accuracy of the Recognizing Acute Delirium as Part of Your Routine (RADAR) Scale for Delirium Assessment in Hospitalized Older Adults: A Cross-Sectional Study.

Delirium is highly prevalent among hospitalized older adults and is associated with unfavorable outcomes. However, delirium often remains undiagnosed in the hospital context. Having a valid, simple, and fast screening tool could help in limiting the additional workload for healthcare professionals, without leaving delirium undetected. The aim of this study was to estimate the sensitivity and specificity of the Recognizing Acute Delirium As part of your Routine (RADAR) scale in an Italian hospital. An observational cross-sectional study was conducted. A total of 150 patients aged ≥70 years were enrolled. Receiver operating characteristic (ROC) curves using the Confusion Assessment Method (CAM) criterion-defined delirium as the gold standard were plotted to evaluate the performance of the RADAR scale. The cut-off suggested by previous research was used to estimate the sensitivity, specificity, and positive and negative predictive values of the RADAR scale. The involved patients were mostly females (60%; n = 90), with a median age of 84 years (I-III quartiles: 80-88). According to the CAM and the RADAR scale, 37 (25%) and 58 (39%) patients were classified as experiencing delirium, respectively. The area under the ROC curve of the RADAR scale was 0.916. Furthermore, the RADAR scale showed robust sensitivity (95%), specificity (80%), and positive (60%) and negative predictive values (98%). The RADAR scale is thus suggested to be a valid tool for screening assessment of delirium in hospitalized older adults.

Chuna Manual Therapy or Electroacupuncture with Pregabalin for Chemotherapy-Induced Peripheral Neuropathy: A Randomized Controlled Pilot Study.

Background: Chemotherapy-induced peripheral neuropathy (CIPN) is one of the most common side effects of chemotherapy, and effective treatments for CIPN are still lacking. For this reason, there is a growing interest in complementary and alternative medicine as a potential source of nonsurgical treatments for CIPN symptoms alongside pregabalin. One such option being explored is Chuna manual therapy (CMT), a traditional Korean manual therapy. Methods: This study compares the effectiveness and safety of using only pregabalin (PG) as a conventional method of treating breast and colorectal cancer patients with CIPN symptoms with a combination of both PG and electroacupuncture (EA) or CMT, while also assessing the feasibility of future large-scale clinical studies. Due to the COVID-19 pandemic, only 74 CIPN patients were recruited to this study. Twenty-five were assigned to the PG group, 26 to the PG + EA group, and 22 to the PG + CMT group for a five-week treatment and a four-week follow-up study. Results: For the primary outcome, we evaluated the mean differences in Functional Assessment of Cancer Therapy/Gynecologic Oncology Group-Neurotoxicity (FACT/GOG-Ntx) compared to the baseline at week 5 (visit 4). Although we found that the PG + CMT group showed the biggest difference (-16.64 [95% CI: -25.16, -8.11]) compared to the PG group (-8.60 [95% CI: -14.93, -2.27]) and the PG + EA group (-6.73 [95% CI: -12.34, -1.13]), this finding lacked statistical significance (p = 0.2075). In terms of safety, two patients in the PG + CMT group reported side effects: one bruise and one headache. Conclusions: The low attrition and high adherence rates of all the groups, and the similar rates of side effects among them, support the feasibility of larger-scale follow-up studies.

3D-printed shell complete dentures as a diagnostic aid for implant planning and fabricating interim restorations for complete arch rehabilitations: A case series.

3D-printed shell complete dentures generated from a scan of the patient's existing prostheses can simplify and expedite the surgical planning and interim restoration design for complete arch rehabilitations. Three patients were rehabilitated with endosteal implants, and interim restorations were generated from the contours of the 3D-printed shell complete dentures used as diagnostic aids. This case series report presents the recommended protocol and its clinical progression, in addition to clinical and radiographic images of the treatment outcomes.

CSXAI: a lightweight 2D CNN-SVM model for detection and classification of various crop diseases with explainable AI visualization.

Plant diseases significantly impact crop productivity and quality, posing a serious threat to global agriculture. The process of identifying and categorizing these diseases is often time-consuming and prone to errors. This research addresses this issue by employing a convolutional neural network and support vector machine (CNN-SVM) hybrid model to classify diseases in four economically important crops: strawberries, peaches, cherries, and soybeans. The objective is to categorize 10 classes of diseases, with six diseased classes and four healthy classes, for these crops using the deep learning-based CNN-SVM model. Several pre-trained models, including VGG16, VGG19, DenseNet, Inception, MobileNetV2, MobileNet, Xception, and ShuffleNet, were also trained, achieving accuracy ranges from 53.82% to 98.8%. The proposed model, however, achieved an average accuracy of 99.09%. While the proposed model's accuracy is comparable to that of the VGG16 pre-trained model, its significantly lower number of trainable parameters makes it more efficient and distinctive. This research demonstrates the potential of the CNN-SVM model in enhancing the accuracy and efficiency of plant disease classification. The CNN-SVM model was selected over VGG16 and other models due to its superior performance metrics. The proposed model achieved a 99% F1-score, a 99.98% Area Under the Curve (AUC), and a 99% precision value, demonstrating its efficacy. Additionally, class activation maps were generated using the Gradient Weighted Class Activation Mapping (Grad-CAM) technique to provide a visual explanation of the detected diseases. A heatmap was created to highlight the regions requiring classification, further validating the model's accuracy and interpretability.