Icon for the treatment of postorthodontic white spot lesions. 2-year follow-up.

The objective of the present case report is to describe Icon resin infiltration as a treatment option for postorthodontic white spot lesions (WSLs). A 23-year-old male patient complained of white spots on his maxillary anterior teeth that caused him significant esthetic concern in terms of his smile and affected his self-esteem. During the anamnesis, the patient reported that he noticed white spots directly after the brackets were removed after orthodontic treatment, which had not yet been completed. Based on the information obtained through the anamnesis and the clinical examination, the spots were deemed to be remineralized WSLs. The proposed treatment consisted of supervised at-home tooth whitening through bleaching in combination with microabrasion and resin infiltration. The clinical results were successful, showing significant improvement in terms of esthetics and the patient's self-esteem after only a single session of resin infiltration with Icon material. Treatment optimization and gain in clinical time were clearly demonstrated as well as the preservation of tooth tissue compared with other treatments.

A single-session stereotactic radiosurgery for vagal paraganglioma: Effective tumor reduction and innovative treatment option.

Background: Vagal paragangliomas (VPs) are rare tumors in the upper cervical region. Although surgical resection is the standard treatment for these tumors, it carries significant risks due to the tumor's high vascularity and proximity to vital structures. Stereotactic radiosurgery (SRS) for skull base paraganglioma could be a minimally invasive alternative. Case Description: We report the case of a 47-year-old man with a large, asymptomatic VP who was successfully treated with SRS with Gamma Knife Icon, which was performed in the parapharyngeal space (volume: 25.7 mL) using a marginal dose of 14 Gy to the 45% isodose line. This case illustrates the successful treatment of a lesion near the conventional limits (lower limit of C2 vertebral body) using noninvasive mask fixation. Excellent tumor control without neurological deficits was achieved for 25 months after SRS. The tumor volume decreased by 70% (final volume: 7.6 mL). Conclusion: This study demonstrates the utility of Gamma Knife Icon, which facilitates optimal SRS for upper cervical lesions, including VPs.

Microleakage Assessment of Modified Resin Infiltration With Zinc Oxide (ZnO) and Magnesium Oxide (MgO) Nanoparticles on Artificial Enamel Caries Lesion: An In Vitro Study.

Background Incorporating nanoparticles into resin infiltrant (RI) can alter its physical properties, including microleakage. This study aimed to examine the microleakage properties of RI modified with 2.5% and 5% zinc oxide (ZnO) and magnesium oxide (MgO) nanoparticles on artificially induced carious lesions (ACLs) in bovine teeth. Materials and methods Modified RIs were applied to five sound and 30 ACLs on bovine incisors. They were divided into seven groups based on the procedure (Group 1: sound enamel (SE), Group 2: artificial caries lesion only (ACL), Group 3: RI, Group 4: RI+ 2.5% ZnO, Group 5: RI + 5% ZnO, Group 6: RI + 2.5% MgO, Group 7: RI + 5% MgO). The samples were subjected to 5000 thermal cycles and then exposed to methylene blue solution for 24 hours in an incubator. The teeth were sectioned and examined with a stereomicroscope to assess the depth of methylene blue penetration (MBP), quantifying microleakage according to the following scoring: 0 = no penetration, 1 = outer half of enamel, 2 = inner half of enamel, 3 = outer half of dentin, and 4 = inner half of dentin. An ANOVA test was conducted to assess the significance of differences among the groups. Post-hoc tests, including Tukey's HSD (honestly significant difference) test, were performed to identify specific group differences and determine which differences were statistically significant. Results SE samples (Group 1) showed minimal penetration, with 100% scoring 1, indicating high resistance to MBP. The ACL group had significant penetration, with 77.78% scoring 3 and 22.22% scoring 2. The RI group completely prevented MBP, with all samples scoring 0. Both RI+2.5% ZnO (Group 4) and RI+2.5% MgO (Group 6) were highly effective, with 88.89% scoring 0 and 11.11% scoring 1. RI+5% ZnO (Group 5) and RI+5% MgO (Group 7) also prevented MBP but had slightly higher minimal penetration, with 77.78% scoring 0 and 22.22% scoring 1. Significant differences were observed between the ACL group and all other groups, underscoring the effectiveness of RI treatments. No significant differences were found between RI+ZnO and RI+MgO at both concentrations, indicating similar effectiveness. Conclusions The study demonstrated that RI modified with 2.5% and 5% ZnO and MgO nanoparticles effectively reduced microleakage in ACLs on bovine teeth compared to untreated lesions. These modifications significantly inhibited MBP, particularly in enamel and dentin, indicating their potential to enhance the durability and effectiveness in clinical applications. This research emphasizes the promising role of nanoparticle-modified RI in minimizing microleakage and optimizing treatment outcomes. Further research is needed to confirm these findings and refine protocols.

Evaluation of Penetration Depth and Caries Progression using Resin Infiltrant in Natural White Spot Lesions of Primary Molars.

Background: Management of white spot lesions (WSLs) using resin infiltrants, like ICON®, is a novel technique that emphasizes the concept of minimally invasive dentistry. Aim: Evaluate penetration depth and its effect on caries progression of ICON® in natural WSLs of primary molars. Design: A total of 30 human primary molars with natural WSLs were selected. A total of 15 samples each were randomly selected to evaluate penetration depth and caries progression. To evaluate penetration depth, lesion surfaces were sectioned into two halves, wherein one half served as control, while the other half received ICON® infiltration treatment. To evaluate the effect on caries progression, samples were sectioned into two halves, wherein one half served as a control to its experimental counterpart, which received ICON® infiltration. The initial depth of the subsurface lesion (baseline data) was measured, and all the sample subsets underwent pH cycling. Confocal laser fluorescence microscope (CFLM) evaluation was performed, and penetration depth was assessed using a laser scanning microscopy (LSM) image reader, while caries progression was evaluated using PhotoScape® software. Results: ICON® resin infiltrant penetrated to significant depths into the WSLs (p < 0.001) and demonstrated significant inhibition of caries progression (p < 0.001). Conclusion: The novel technique using ICON® could be an invaluable tool in the management of WSLs in primary teeth. How to cite this article: Babu G, Mallikarjun S, Vijayan V, et al. Evaluation of Penetration Depth and Caries Progression using Resin Infiltrant in Natural White Spot Lesions of Primary Molars. Int J Clin Pediatr Dent 2024;17(4):390-394.

Less is Better than More: Anthropomorphic App Icons With Small versus Large Tilt Angles Were Perceived as More Vivid.

In this study, we explored the impact of tilted designs of anthropomorphic app icons on users' perceptions of icon vividness across three experiments. In Experiment 1, tilting with an angle of 45° to the left increased perceived icon vividness. In Experiment 2, sequential icon tilt angles at 30° intervals manipulation showed that small tilt angles (e.g., 30° to the left or right) enhanced participant perceptions of dynamism and vividness, and participants perceived greater vividness in anthropomorphic app icons with slight tilting, driven by this increased dynamism. In Experiment 3, we excluded the effect of the completeness of icons on these participants' evaluations and affirmed that slightly tilting designs was an effective visual strategy for improving perceived vividness to attract users.

Icon Arrays for Medical Risk Communication: Do Icon Type and Color Influence Cardiovascular Risk Perception and Recall?

BACKGROUND: Icon arrays have been shown to be an effective method for communicating medical risk information. However, in practice, icon arrays used to visualize personal risks often differ in the type and color of the icons. The aim of this study was to examine the influence of icon type and color on the perception and recall of cardiovascular risk, as little is known about how color affects the perception of icon arrays. METHODS: A total of 866 participants aged 40 to 90 years representative of the German population in terms of gender and age completed an online experiment. Using a 2 × 2 between-subjects design, participants were randomly assigned to 1 of 4 experimental groups. They received their hypothetical 10-year cardiovascular risk using an icon array that varied by icon type (smiley v. person) and color (black/white v. red/yellow). We measured risk perception, emotional response, intentions of taking action to reduce the risk (e.g., increasing one's physical activity), risk recall, and graph evaluation/trustworthiness, as well as numeracy and graphical literacy. RESULTS: Icon arrays using person icons were evaluated more positively. There was no effect of icons or color on risk perception, emotional response, intentions of taking action to reduce the risk, or trustworthiness of the graph. While more numerate/graphical literate participants were more likely to correctly recall the presented risk estimate, icon type and color did not influence the probability of correct recall. CONCLUSIONS: Differences in the perception of the tested icon arrays were rather small, suggesting that they may be equally suitable for communicating medical risks. Further research on the robustness of these results across other colors, icons, and risk domains could add to guidelines on the design of visual aids. HIGHLIGHTS: The use of different icons and colors did not influence the perception and the probability of recalling the 10-year cardiovascular risk, the emotional response, or the intentions to reduce the presented risk.Icon arrays with person icons were evaluated more positively.There was no evidence to suggest that the effectiveness of the studied icon arrays varied based on individuals' levels of numerical or graphical literacy, nor did it differ between people with or without a history of CVD or on medication for an increased CVD risk.

Long-lasting residual efficacy of Actellic®300CS and Icon®10CS on different surfaces against Anopheles stephensi, an invasive malaria vector.

BACKGROUND: Anopheles stephensi, a malaria-transmitting mosquito species, has developed resistance to various insecticides such as DDT, Dieldrin, Malathion, and synthetic pyrethroids. To combat this issue, the World Health Organization (WHO) suggests using Actellic®300CS and Icon®10CS for Indoor Residual Spraying to tackle pyrethroid-resistant mosquitoes. The aim of this research project was to evaluate the susceptibility of An. stephensi to certain insecticides at the diagnostic concentration + intensity 5x diagnostic concentration (5XDC) assays in Iran and to study the lasting effectiveness of Actellic®300CS and Icon®10CS against this particular malaria vector. METHODS: This study assessed the susceptibility of An. stephensi populations in southern Iran to various insecticides, including deltamethrin 0.05%, DDT 4%, malathion 5%, bendiocarb 0.1%, a synergist assay with PBO 4% combined with deltamethrin 0.05%, and an intensity assay using 5x the diagnostic concentration of deltamethrin (0.25%) and bendiocarb 0.5%. Laboratory cone bioassay tests were conducted to determine the residual effectiveness of Actellic®300 and Icon®10CS insecticides on different surfaces commonly found in households, such as cement, mud, plaster, and wood. The tests were carried out following the WHO test kits and standard testing protocols. RESULTS: The An. stephensi populations in Bandar Abbas were found to be susceptible to malathion 5% and deltamethrin 0.25% (5XDC), but exhibited resistance to DDT, standard concentration of deltamethrin, and both standard and intensity concentrations of bendiocarb. In laboratory cone bioassay tests, An. stephensi mortality rates when exposed to Actellic®300CS and Icon®10CS on different surfaces remained consistently more than 80%. Actellic®300CS achieved more than 80% mortality on all substrates for the entire 300-day post-spraying period. Conversely, Icon®10CS maintained mortality rates more than 80% on plaster and wood surfaces for 165 days and on mud and cement surfaces for 270 days post-spraying. Both Actellic®300CS and Icon®10CS demonstrated 100% mortality within 72 h of each test on all surfaces throughout the entire 300-day post-spraying period. CONCLUSION: The study shows the varying levels of resistance of An. stephensi Bandar Abbas population to different insecticides and demonstrates the consistent performance of Actellic®300CS in controlling these mosquitoes on various surfaces. The findings suggest that long-lasting CS formulations may be more effective for malaria vector control compared to the current options. Further research is needed to validate these findings in field settings and assess the impact of these insecticides on malaria transmission.

A study on the impact of icon structural features in human-computer interface on visual search efficiency.

This article, from the perspective of structural features, focuses on in-car user interface icons and explores the impact of different icon structural features on visual search efficiency. Initially, we categorised the icons into four groups based on structural features: individual structure icons (ISI), enclosed structure icons (ESI), horizontal structure icons (HSI) and vertical structure icons (VSI). Subsequently, we conducted a visual search experiment with structure as the sole variable, recording participants' behaviours and eye-tracking data. Finally, data analysis was conducted using methods including analysis of variance and logistic regression. The results indicate that differences in icon structural features significantly affect visual search efficiency, showcasing significant intergroup differences. HSI exhibit the highest visual search efficiency, while ESI show the lowest efficiency. ISI have shorter response times but the lowest matching accuracy. VSI only perform better than ESI. These findings hold significant implications for optimising icon design and enhancing visual search efficiency.

Visual search efficiency of icons is crucial for human-computer interaction. We investigated how the structural features of icons influence visual search efficiency. Horizontal icons are most effective, enclosed icons the least. Individual icons are quick but less accurate. Vertical icons outperform enclosed ones. Structural features should be considered in design.

Probability overestimation induced by icon arrays.

In decision making under risk, where the consequences of choices vary depending on specific probabilities, a proper interpretation of the presented probabilities is essential. However, because people are not good at evaluating numerical values, such as percentages, efforts have been made to accurately convey presented probabilities using visual aids represented by icon arrays. However, previous studies have suggested that icon arrays produce an overestimation of probabilities under specific conditions. Especially, (a) the arrangement of highlighted icons and (b) the severity of the outcomes represented by highlighted icons can lead to an overestimation of probabilities. By considering the absolute estimation of probabilities indicated by icon arrays and manipulating the aforementioned factors, this study investigated whether these factors could elicit an overestimation of probabilities in an additive manner or whether they have interactive effects. Two studies (total N = 1171) consistently showed that the arrangement of highlighted icons and the outcome severity they indicate induced a perceptual bias in the estimation of the probabilities presented in icon arrays in an additive manner. When the highlighted icons were random and the outcomes they indicate were severe, the probabilities presented by the icon arrays were overestimated. Accordingly, the study not only confirms the robustness of the findings of previous studies but also expand our understanding of the probability overestimation caused by icon arrays. Here, we discuss our findings in terms of the impact of risk-related communication.

Equivalence study of the resin-dentine interface of internal tunnel restorations when using an enamel infiltrant resin with ethanol-wet dentine bonding.

This preregistered ex vivo investigation examined the dentinal hybrid layer formation of a resinous infiltrant (Icon), with reference to both thickness (HLT) and homogeneity when combined with modified tunnel preparation (occlusal cavity only) and internal/external caries infiltration. The adhesives Syntac and Scotchbond MP were used as controls (Groups 1 and 3) or in combination with Icon (Groups 2 and 4). A split-tooth design using healthy third molars from 20 donors resulted in 20 prepared dentine cavities per experimental group. The cavity surfaces (n = 80) were etched (37% H3PO4), rinsed, and air-dried. Rewetting with ethanol was followed by application of the respective primers. After labeling with fluorescent dyes, either Syntac Adhesive/Heliobond or Scotchbond MP Adhesive was used alone or supplemented with Icon. HLT, as evaluated by scanning electron microscopy, did not significantly differ (P > 0.05), and confocal laser scanning microscopy revealed homogeneously mixed/polymerized resin-dentine interdiffusion zones in all groups. Icon can be successfully integrated into an ethanol-wet dentine bonding strategy, and will result in compact and homogeneous hybrid layers of comparable thickness considered equivalent to the non-Icon controls, thus allowing for preservation of the tooth's marginal ridge and interdental space in the case of internal/external infiltration of proximal caries.

Culture and self-construal in the age of globalization: an empirical inquiry based on multiple approaches.

Introduction: There are three main types of culture in human society, namely, individual-oriented, relationship-oriented and social-oriented cultures. In history, there are two main positions on the relationship between culture and self-construal: the cultural determinist position and the interaction position. After analyzing literature critically, we propose that the interaction position is more persuasive than the cultural determinist position. A self-construal model was constructed from an interactionist and polycultural perspective, pointing out the relationship between three cultures and self-construal. We argue that individuals interacting with cultures in the context of globalization can develop a more integrated self-construal. The present study proposes the existence of polycultural self-construal, and aimed to explore how self-construal factors relate to cultures. Methods: Three approaches-psychological tests, priming with cultural icons and content analysis-were used to explore mechanisms between cultures (individual-oriented, relationship-oriented, and social-oriented cultures) and self-construal. In Study 1, we recruited 460 undergraduate students as participants through campus advertising to complete three psychological tests, namely, the Cultural Identity Scale (CIS), the Marlowe-Crowne Social Approval Scale (MC-SDS), and the Polycultural Self-construal Scale (PSCS). In Study 2, we created icon materials that could prime the three cultures. The experimental process was divided into two stages: priming and measurement. First, 165 participants were presented with icon materials on the computer screen to activate the corresponding culture, and then they were asked to complete the PSCS. In Study 3, the experimental procedures were followed as for Study 2. Then the Ten Statements Test (TST) was used. Each of the 178 participants gave 10 different responses to the question of "Who am I?." Each participant's "I am …" narratives were qualitatively processed using content analysis. Results: The individual-oriented culture mainly affects the individuality and equality factor of self-construal. The relationship-oriented culture mainly impacts the relationality factor of self-construal, while the social-oriented culture mainly affects the collectivity and equality factors of self-construal. There were no significant differences in the effects of the three cultures on the autonomy factor of self-construal. The multi-components of the polycultural self-construal are difficult to interpret based on one culture type. All three cultures have specific and shared effects on human self-construal.

Long-term geometric quality assurance of radiation focal point and cone-beam computed tomography for Gamma Knife radiosurgery system.

To investigate the geometric accuracy of the radiation focal point (RFP) and cone-beam computed tomography (CBCT) over long-term periods for the ICON Leksell Gamma Knife radiosurgery system. This phantom study utilized the ICON quality assurance tool plus, and the phantom was manually set on the patient position system before the implementation of treatment for patients. The deviation of the RFP position from the unit center point (UCP) and the positions of the four ball bearings (BBs) in the CBCT from the reference position were automatically analyzed. During 544 days, a total of 269 analyses were performed on different days. The mean ± standard deviation (SD) of the deviation between measured RFP and UCP was 0.01 ± 0.03, 0.01 ± 0.03, and -0.01 ± 0.01 mm in the X, Y, and Z directions, respectively. The deviations with offset values after the cobalt-60 source replacement (0.00 ± 0.03, -0.01 ± 0.01, and -0.01 ± 0.01 mm in the X, Y, and Z directions, respectively) were significantly (p = 0.001) smaller than those before the replacement (0.02 ± 0.03, 0.02 ± 0.01, and -0.02 ± 0.01 mm in the X, Y, and Z directions, respectively). The overall mean ± SD of four BBs was -0.03 ± 0.03, -0.01 ± 0.05, and 0.01 ± 0.03 mm in the X, Y, and Z directions, respectively. Geometric positional accuracy was ensured to be within 0.1 mm on most days over a long-term period of more than 500 days.

Designing and implementing a new icon-based difficult airway cart: a two-phase prospective qualitative improvement project.

PURPOSE: The difficult airway cart is essential for difficult airway management. Recognition of the importance of human factors in critical scenarios promoted the evolution of the difficult airway cart. Limitation to essential equipment, a structured layout, and proper labelling should be observed. We sought to redesign the difficult airway cart accordingly and analyze how perioperative professionals reacted to it. METHODS: We conducted a two-phase prospective qualitative improvement project involving a multidisciplinary team. In phase 1, we reconfigured our difficult airway cart, including developing icons for labelling the drawers and discussing the equipment content. In phase 2, we delivered a multidisciplinary educational program and pre- and postsession questionnaires were administered to the professionals involved and compared. RESULTS: Phase 1 of the project encompassed 21 participants. We presented the final layout and content of the difficult airway cart. In phase 2, 44 participants responded the presession questionnaires, and 30 participants answered the postsession questionnaires. The results showed that the new design and the implementation program increased the comfort level of professionals involved in a potential airway crisis (presession mean [standard deviation (SD)]: anesthesiologists, 8.0 [1.9]; anesthesia assistants/respiratory therapists [AAs/RTs], 9.3 [0.8]; operating room registered nurses [OR RNs], 6.3 [2.7]; P = 0.001; postsession: anesthesiologists, 8.5 [2.0]; AAs/RTs, 9.6 [0.5]; OR RN, 7.9 [2.0]; P = 0.10). Nevertheless, the improvement was only statistically significant among the OR RNs (presession mean [SD]: 6.3 [2.7]; postsession: 7.9 [2.0]; P = 0.01). Additionally, the program facilitated the recognition of the location of airway equipment in the airway cart (positive responses ranging from 97% to 100%). CONCLUSION: Our quality improvement project successfully designed and implemented a new visual-based difficult airway cart at our institution. We believe this report enables other institutions to reproduce our project.

RéSUMé: OBJECTIF: Le chariot d'intubation difficile est essentiel pour la prise en charge des voies aériennes difficiles. La reconnaissance de l'importance des facteurs humains dans les situations critiques a favorisé l'évolution du chariot d'intubation difficile. Il est crucial de se limiter à l'équipement essentiel tout en organisant les éléments de manière structurée et en les étiquetant adéquatement. Nous avons cherché à repenser le chariot d'intubation difficile en gardant ces éléments à l'esprit et à analyser la réaction des professionnel·les oeuvrant en périopératoire. MéTHODE: Nous avons réalisé un projet d'amélioration qualitative prospective en deux phases impliquant une équipe multidisciplinaire. Au cours de la phase 1, nous avons reconfiguré notre chariot d'intubation difficile, en développant notamment des icônes pour étiqueter les tiroirs et en discutant du contenu matériel. Au cours de la phase 2, nous avons mis en place un programme éducatif multidisciplinaire et des questionnaires ont été administrés aux professionnel·les concerné·es avant et après la session. RéSULTATS: La phase 1 du projet a réuni 21 participant·es. Nous avons présenté la disposition finale et le contenu du chariot d'intubation difficile. Au cours de la phase 2, 44 participant·es ont répondu aux questionnaires d'avant-session et 30 participant·es ont répondu aux questionnaires d'après-session. Les résultats ont montré que la nouvelle disposition avec icônes et le programme de mise en œuvre ont augmenté le niveau de confort des professionnel·les impliqué·es dans une situation critique potentielle impliquant les voies aériennes (moyenne avant la séance [écart type (ET)] : anesthésiologistes, 8,0 [1,9]; assistant·es en anesthésie/inhalothérapeutes, 9,3 [0,8]; personnel infirmier autorisé en salle d'opération (SOP), 6,3 [2,7]; P = 0,001; après la session : anesthésiologistes, 8,5 [2,0]; assistant·es en anesthésie/inhalothérapeutes, 9,6 [0,5]; personnel infirmier de SOP, 7,9 [2,0]; P = 0,10). Néanmoins, l'amélioration n'était statistiquement significative que chez le personnel infirmier autorisé de SOP (moyenne avant la session [ET] : 6,3 [2,7]; après la session : 7,9 [2,0]; P = 0,01). De plus, le programme a facilité la reconnaissance de l'emplacement de l'équipement pour les voies aériennes dans le chariot d'intubation (réponses positives allant de 97 % à 100 %). CONCLUSION: Dans le cadre de notre projet d'amélioration de la qualité, nous avons réussi à concevoir et mettre en œuvre un nouveau chariot d'intubation difficile avec icônes dans notre établissement. Nous pensons que ce compte rendu permettra à d'autres institutions de reproduire notre projet.

Management of permanent incisors affected by Molar-Incisor-Hypomineralisation (MIH) using resin infiltration: a pilot study.

PURPOSE: To compare the aesthetic improvement of Molar-Incisor-Hypomineralisation (MIH) opacities treated by applying Icon-Etch for three cycles with the opacities treated by Icon-Etch for once, in the course of resin infiltration technique. METHODS: Thirty incisors were sorted based on the colour of the opacities and then distributed according to the number of Icon-Etch cycles using a randomisation table into the groups: (1) White/Creamy one cycle, (2) White/Creamy three cycles, (3) Yellow/Brown one cycle, (4) Yellow/Brown three cycles. The primary outcomes of applying the resin infiltration to the opacities were compared amongst groups according to the parents' satisfaction, the amount of coverage, and the colour matching with the surrounding sound enamel. The stability of the results after 3 months was evaluated using a spectrophotometer. RESULTS: The colour of the opacity pre-treatment affected the outcomes significantly (p < 0.05), compared according to the method of application (p > 0.05) in terms of parents' satisfaction. Whilst the multiple applications for Icon-Etch cycles showed more coverage amount in White/Creamy opacities than the application ones (p < 0.05); in colour matching, there was no statistically significant difference between the two methods (p > 0.05). For yellow/brown opacities, some negative results occurred with the single Icon-Etch cycle. CONCLUSION: In MIH opacities, it is possible to rely on the resin infiltration as a minimally invasive method to achieve acceptable results, especially with multiple Icon-Etch cycles applications in the white/creamy opacities. The colour stability has not been affected by either the colour of the opacity or the number of cycles.

Fetal Dose Evaluation for Pregnant Patients on Leksell Gamma Knife Perfexion/Icon.

INTRODUCTION: It is a normal procedure to avoid the application of ionizing radiation during pregnancy. In very rare occasions, treatment can be performed, but doses to the fetus must be evaluated and reported, and the patient must sign informed consent. There can occur two types of damage caused by ionizing radiation - deterministic and stochastic effects. Deterministic effects may occur after reaching a certain threshold (100 mGy for this study); meanwhile, stochastic effects have no limit and their probability rises with dose. This study focuses on deterministic effects. CASE PRESENTATIONS: This study compares the dose measured on phantom for the area of the pelvis and the dose measured on 3 patients with dosimeters positioned on the pelvis irradiated on Leksell Gamma Knife Perfexion/Icon. The mean dose for measurement on phantom for the pelvis was 0.73 ± 0.76 mGy, and for the patients, it was 1.28 mGy, 0.493 mGy, and 0.549 mGy which is 80 times lower, 200 times lower, and 180 times lower than the threshold for deterministic effects, respectively. CONCLUSION: The measurement carried on phantom served as the base for drafting informed consent and provided initial proof that treatment can be safely delivered. Measurements performed on patients only confirmed that irradiation of pregnant patients on Leksell Gamma Knife Perfexion/Icon is safe relative to the deterministic effects. Nevertheless, pregnant patients should be treated with ionizing radiation only in very extraordinary situations.

Effects of background colour, polarity, and saturation on digital icon status recognition and visual search performance.

Visual design form is an important factor affecting users' cognition of icons, which plays an important role in visual search and the perception of the status shown by icons. In the graphical user interface, the icon colour is regularly used to indicate the running state of a function. The aim of this study was to investigate the effects of icon colour features on user perception and visual search performance under different background colours. There were three independent variables in the study, including background colour (white and black), icon polarity (positive and negative), and icon saturation (60, 80, and 100%). Thirty-one participants were recruited for the experiment. Task performance and eye movement results indicated that white background as well as positive polarity and 80% saturation icons brought the best performances. The findings of this study provide useful guidelines for designing more efficient and user-friendly icons and interfaces in the future.Practitioner summary: This study was to investigate the effects of icon colour features (polarity and saturation) on user perception and visual search performance under different colour backgrounds. Task performance and eye movement results indicated that white background as well as positive polarity and 80% saturation icons brought the best performances.

Fibroblast Growth Factor Receptors and Ligands in Context of Bevacizumab Response in Ovarian Carcinoma: An Exploratory Analysis of AGO-OVAR11/ICON-7.

With more novel drugs being approved for the treatment of ovarian carcinoma, the question remains to what extent patients benefit from antiangiogenic treatment with bevacizumab, either in combination with poly-(ADP-ribose) polymerase inhibitors or as single-agent maintenance. As fibroblast growth factor receptors and their ligands (FGFRs/FGFs) are key players in angiogenic signaling and have been linked to resistance to several drugs, we investigated the prognostic or predictive potential of FGFs/FGFRs signaling in the context of bevacizumab treatment within the prospective phase III AGO-OVAR11/ICON-7 study. FGFR1, FGFR2, FGFR3, FGFR4, FGF1, and FGF19 gene expressions were determined in 380 ovarian carcinoma tumor samples collected from German centers in the multicenter phase III AGO-OVAR11 trial/ICON-7 trial. All patients received carboplatin and paclitaxel, administered every 3 weeks for 6 cycles, and were randomized to bevacizumab. Expressions of FGFR1, FGFR2, FGF1, and FGF19 were associated with progression-free survival in both uni- and multivariate (FGFR1: HR, 1.6, P < .001; FGFR2: HR, 1.6, P = .002; FGF1: HR, 2.3, P < .001; and FGF19: HR, 0.7; P = .007) analysis. A signature built by FGFR1, FGFR4, and FGF19 defined a subgroup (n = 62) of patients that derived the greatest bevacizumab-associated improvement of progression-free survival (HR, 0.3; P = .004). In this exploratory analysis of a prospective randomized phase III trial, we provide evidence that the expression of FGFRs/FGFs might have independent prognostic values. An FGFR/FGF-based gene signature identified in our study appears to predict long-term benefit from bevacizumab. This observation is hypothesis-generating and requires validation on independent cohorts.

Medium-Term Clinical Outcomes of the Global Icon Stemless Shoulder System: Results of a 2-Year Follow-Up.

The primary aim of this study was to assess the medium-term outcomes of the Global Icon stemless shoulder replacement in patients who have undergone primary total shoulder arthroplasty (TSA) for glenohumeral joint osteoarthritis. A retrospective review of patients who had undergone a TSA using the Global Icon stemless shoulder system was performed. The Western Ontario Osteoarthritis Shoulder (WOOS) Index and Oxford Shoulder Score (OSS) were evaluated pre-operatively and at 12 to 24 months post-operatively. Radiological outcomes, operation time, and post-operative complications were reported. Primary analysis for the WOOS Index and OSS focused on detecting within-group treatment effects at 24 months using a repeated measures ANOVA. Thirty patients were included in the study. Post-surgery, there was a significant improvement at 24 months on the OSS (ES = 0.932, CI: 41.7 to 47.7, p < 0.001) and the WOOS Index (ES = 0.906, CI: 71.9 to 99.8, p < 0.001). Radiographs revealed that no component loosened, migrated, or subsided. The median operative time was 75.5 (IQR: 12.25, range: 18 to 105) min. No implant-related complications were reported. The Global Icon stemless replacements have excellent clinical outcomes in this cohort at 12- and 24-month follow-up with no implant-related complications.

The Lure of Beauty: People Select Representations of Statistical Information Largely Based on Attractiveness, Not Comprehensibility.

OBJECTIVE: People differ in whether they understand graphical or numerical representations of statistical information better. However, assessing these skills is often not feasible when deciding which representation to select or use. This study investigates whether people choose the representation they understand better, whether this choice can improve risk comprehension, and whether results are influenced by participants' skills (graph literacy and numeracy). METHODS: In an experiment, 160 participants received information about the benefits and side effects of painkillers using either a numerical or a graphical representation. In the "no choice" condition, the representation was randomly assigned to each participant. In the "choice" condition, participants could select the representation they would like to receive. The study assessed gist and verbatim knowledge (immediate comprehension and recall), accessibility of the information, attractiveness of the representation, as well as graph literacy and numeracy. RESULTS: In the "choice" condition, most (62.5%) chose the graphical format, yet there was no difference in graph literacy or numeracy (nor age or gender) between people who chose the graphical or the numerical format. Whereas choice slightly increased verbatim knowledge, it did not improve gist or overall knowledge compared with random assignment. However, participants who chose a representation rated the representation as more attractive, and those who chose graphs rated them as more accessible than those without a choice. LIMITATIONS: The sample consisted of highly educated undergraduate students with higher graph literacy than the general population. The task was inconsequential for participants in terms of their health. CONCLUSIONS: When people can choose between representations, they fail to identify what they comprehend better but largely base that choice on how attractive the representation is for them. HIGHLIGHTS: People differ systematically in whether they understand graphical or numerical representations of statistical information better. However, assessing these underlying skills to get the right representation to the right people is not feasible in practice. A simple and efficient method to achieve this could be to let people choose among representations themselves.However, our study showed that allowing participants to choose a representation (numerical v. graphical) did not improve overall or gist knowledge compared with determining the representation randomly, even though it did slightly improve verbatim knowledge.Rather, participants largely chose the representation they found more attractive. Most preferred the graphical representation, including those with low graph literacy.It would therefore be important to develop graphical representations that are not only attractive but also comprehensible even for people with low graph literacy.

How Do People Process Different Representations of Statistical Information? Insights into Cognitive Effort, Representational Inconsistencies, and Individual Differences.

BACKGROUND: Graphical representation formats (e.g., icon arrays) have been shown to lead to better understanding of the benefits and risks of treatments compared to numbers. We investigate the cognitive processes underlying the effects of format on understanding: how much cognitive effort is required to process numerical and graphical representations, how people process inconsistent representations, and how numeracy and graph literacy affect information processing. METHODS: In a preregistered between-participants experiment, 665 participants answered questions about the relative frequencies of benefits and side effects of 6 medications. First, we manipulated whether the medical information was represented numerically, graphically (as icon arrays), or inconsistently (numerically for 3 medications and graphically for the other 3). Second, to examine cognitive effort, we manipulated whether there was time pressure or not. In an additional intervention condition, participants translated graphical information into numerical information before answering questions. We also assessed numeracy and graph literacy. RESULTS: Processing icon arrays was more strongly affected by time pressure than processing numbers, suggesting that graphical formats required more cognitive effort. Understanding was lower when information was represented inconsistently (v. consistently) but not if there was a preceding intervention. Decisions based on inconsistent representations were biased toward graphically represented options. People with higher numeracy processed quantitative information more efficiently than people with lower numeracy did. Graph literacy was not related to processing efficiency. LIMITATIONS: Our study was conducted with a nonpatient sample, and the medical information was hypothetical. CONCLUSIONS: Although graphical (v. numerical) formats have previously been found to lead to better understanding, they may require more cognitive effort. Therefore, the goal of risk communication may play an important role when choosing how to communicate medical information. HIGHLIGHTS: This article investigates the cognitive processes underlying the effects of representation format on the understanding of statistical information and individual differences therein.Processing icon arrays required more cognitive effort than processing numbers did.When information was represented inconsistently (i.e., partly numerically and partly graphically), understanding was lower than with consistent representation, and decisions were biased toward the graphically represented options.People with higher numeracy processed quantitative information more efficiently than people with lower numeracy did.