Comparison of cognitive workload and surgical outcomes between a three-dimensional and conventional microscope macular hole surgery.

BACKGROUND: Performing a surgical task subjects the surgeon to multitudinal stressors, especially with the newer 3D technology. The quantum of cognitive workload using this modern surgical system in comparison to the Conventional microscope system remains unexplored. We evaluate the surgeon's cognitive workload and the surgical outcomes of macular hole(MH) surgery performed on a 3D versus a Conventional microscope operating system. METHODS: 50 eyes of 50 patients with MH undergoing surgery using the 3D or Conventional microscope visualization system. Cognitive workload assessment was done by real-time tools(Surgeons' heart rate [HR] and oxygen saturation[SPO2]) and self-report tool(Surgery Task Load Index[SURG-TLX] questionnaire) of three Vitreoretinal surgeons. Based on the SURG-TLX questionnaire, an assessment of the workload was performed. RESULTS: Of the 50 eyes, 30 eyes and 20 eyes underwent surgery with the Conventional microscope and the 3D system, respectively. No difference was noted in the MH basal-diameter(p = 0.128), total surgical-duration(p = 0.299), internal-limiting membrane(ILM) peel time(p = 0.682), and the final visual acuity (VA; p = 0.515) between the two groups. Both groups showed significant improvement in VA(p < 0.001) with a 90% closure rate at one-month post-surgery. Cognitive workload comparison, the intraoperative HR(p = 0.024), total workload score(P = 0.005), and temporal-demand dimension(p = 0.004) were significantly more in Conventional microscope group as compared to 3D group. In both the groups, the HR increased significantly from the baseline while performing ILM peeling and at the end. CONCLUSION: The surgeon's cognitive workload is markedly reduced while performing macular hole surgery with a 3D viewing system. Moreover, duration of surgery including ILM peel time, MH closure rates, and visual outcomes remains unaffected irrespective of the operating microscope system.

Highly Selective MOF-Based Turn-Off Luminescence Detection of Hg2+ Ions in an Aqueous Medium and Its Dual Functional Catalytic Activity toward Aldol Condensation and ß-Enamination Reactions.

A new organic ligand, 5-(carboxyformamido)isophthalic acid (5-CFIA), was prepared and employed for the synthesis of two compounds [M3(C10H4O7N1)2(8H2O)]·H2O (M = Cd, Mn). The compounds have three-dimensionally extended structures. Both the compounds were found to be luminescent at room temperature. The luminescence nature was exploited for the detection of Hg2+ ions in an aqueous medium with good selectivity. The interactions between Hg2+ ions and the compounds quench the luminescence intensity and act as a turn-off sensor. Both the compounds exhibited low limits for the detection of Hg2+ ions and in the range mandated by the WHO. The interactions between Hg2+ ions and the compound involve the -NH group, which was probed using Raman and IR spectroscopic techniques. These studies provide important pointers toward the mechanism of this turn-off luminescence behavior. The compounds were explored for base-catalyzed aldol condensation and Lewis acid-promoted ß-enaminoester formation reactions. The aldol condensation reaction uses the -NH functionality as a base. The studies indicate that the electron-withdrawing group produces products with higher yields. The ß-enaminoester reaction uses the Lewis acid centers, and the studies reveal that the electron-withdrawing groups produce lesser yields of the products. The catalytic nature of the reaction and recyclability of the catalysts were also established. The catalytic reactions employ ethanol (aldol condensation) and no solvent (ß-enaminoester), which suggests that the reactions are green and environmentally friendly. The Mn compound was observed to be anti-ferromagnetic.

A tissue-mimicking prostate phantom for 980 nm laser interstitial thermal therapy.

Purpose: To develop a phantom with optical and thermal properties matched to human prostate. This phantom will provide a platform for the development and characterization of 980 nm laser interstitial thermal therapy (LITT) systems. Methods: A polyacrylamide gel was doped with Naphthol Green B, Intralipid, and Bovine Serum Albumin (BSA). The necessary concentration of each ingredient was determined by measuring the optical properties via fluence measurements and light diffusion theory. LITT was then performed under the same conditions as a previous clinical trial in which temperature was monitored via a thermal probe. The thermal data and induced coagulation zone were compared to clinical data to illustrate the similarity between the phantom and patient. LITT was also performed under magnetic resonance thermometry (MRT). Results: The requisite concentrations of Naphthol Green B, Intralipid and BSA were found to be 0.144% (w/v), 8.06% (v/v) and 31.4% (v/v) respectively. In the native state, the absorption coefficient and reduced scattering coefficient ( µs' ) were found to be 0.66 ± 0.06 cm-1 and 8.27 ± 0.50 cm-1 respectively, with µs' increasing to 17.63 ± 1.41 cm-1 after coagulation. The thermal response of the phantom was similar to that observed clinically with maximum thermal probe measurements of 64.2 °C and 66.9 °C respectively. The shape of the induced coagulation zone was qualitatively and quantitatively similar to the MRT zone of elevated temperature and the coagulation zone observed clinically. Conclusions: A phantom which simulates optical and thermal response to 980 nm LITT was constructed and demonstrated to be similar to human prostate.

Vulvar intraepithelial neoplasia: Risk factors for recurrence.

OBJECTIVE: We studied a large population of women with high-grade vulvar intraepithelial neoplasia (VIN) in order to identify patient and treatment-related risk factors for recurrence and progression to cancer. METHODS: For this retrospective cohort study of women with a histologic diagnosis of VIN within Southern California Permanente Medical Group between 1995 and 2007 medical records were reviewed; clinical, demographic and pathologic data were collected. Statistical analyses included Chi-squared and Student's t-tests, univariate and multivariate logistic regression, and cumulative incidence analysis. RESULTS: 914 patients with high-grade VIN were identified; 784 met inclusion criteria. We found 26.3% recurrences among treated women, with 2.2% progression to cancer (8.2% among those with recurrence). Risk factors for recurrence on multivariate analysis were: age >50years (OR, 1.44; 95%CI 1.01-2.07), immunosuppression (OR 2.08; 95%CI 1.42-3.06), metasynchronous VAIN or CIN (OR 1.76; 95%CI 1.08-2.88) in addition to margin status (OR 8.17; 95%CI 4.60-14.51) and adjacent LSA (OR 9.91; 95%CI 1.53-31.32) or HPV (OR 2.15; 95%CI 1.13-3.37) with excisional treatment. Recurrence rates did not differ significantly by smoking status and treatment modalities. Median time to recurrence was 16.9months; 25% had late recurrences (44-196months). Cumulative incidence analyses of time to recurrence shows a significantly higher risk among patients over age 50 (log-rank p=0.0031). CONCLUSION: We identified independent risk factors for recurrence including age >50years, immunosuppression, metasynchronous vaginal or intraepithelial neoplasia, positive excision margins, and adjacent lichen sclerosus or human papilloma-virus. Regardless of treatment modality, 25% of recurrences occurred late, highlighting the need for long-term surveillance in women treated for VIN.

Utilization of multiparametric prostate magnetic resonance imaging in clinical practice and focal therapy: report from a Delphi consensus project.

PURPOSE: To codify the use of multiparametric magnetic resonance imaging (mpMRI) for the interrogation of prostate neoplasia (PCa) in clinical practice and focal therapy (FT). METHODS: An international collaborative consensus project was undertaken using the Delphi method among experts in the field of PCa. An online questionnaire was presented in three consecutive rounds and modified each round based on the comments provided by the experts. Subsequently, a face-to-face meeting was held to discuss and finalize the consensus results. RESULTS: mpMRI should be performed in patients with prior negative biopsies if clinical suspicion remains, but not instead of the PSA test, nor as a stand-alone diagnostic tool or mpMRI-targeted biopsies only. It is not recommended to use a 1.5 Tesla MRI scanner without an endorectal or pelvic phased-array coil. mpMRI should be performed following standard biopsy-based PCa diagnosis in both the planning and follow-up of FT. If a lesion is seen, MRI-TRUS fusion biopsies should be performed for FT planning. Systematic biopsies are still required for FT planning in biopsy-naïve patients and for patients with residual PCa after FT. Standard repeat biopsies should be taken during the follow-up of FT. The final decision to perform FT should be based on histopathology. However, these consensus statements may differ for expert centers versus non-expert centers. CONCLUSIONS: The mpMRI is an important tool for characterizing and targeting PCa in clinical practice and FT. Standardization of acquisition and reading should be the main priority to guarantee consistent mpMRI quality throughout the urological community.

Multifocal capillary malformations in an older, asymptomatic child with a novel RASA1 mutation.

Multifocal capillary malformation (CM) is the cardinal feature of patients with RASA1 mutations. These CMs are 'red flags', signalling the possible association with an arteriovenous malformation (AVM) or an arteriovenous fistula (AVF). We report an 8-year-old boy who presented with > 20 CMs, who was found to have a novel mutation in the RASA1 gene. Radiological screening of children with RASA1 mutations is not standardized, and we elected to carry out baseline magnetic resonance imaging of the brain and spine in our case, which gave normal results. We discuss the recent literature and our approach in the management of such a case.

Maternal hyperoxygenation improves left heart filling in fetuses with atrial septal aneurysm causing impediment to left ventricular inflow.

OBJECTIVES: Aneurysm of the atrial septum (AAS) with excessive excursion of septum primum into the left atrium is an uncommon and relatively benign fetal condition associated with impediment to left ventricular (LV) filling and the appearance of a slender, but apex-forming, LV on fetal echocardiography. Impediment to filling can be severe, creating the image of LV hypoplasia with retrograde aortic flow. We hypothesize that maternal hyperoxygenation alters atrial septal position, improves LV filling, and normalizes aortic flow in fetuses with AAS by increasing fetal pulmonary venous return. METHODS: Fetal echocardiography was performed prior to, and at 10 min of, maternal hyperoxygenation in 12 fetuses with AAS who were referred to our center because of LV hypoplasia. Atrial septal excursion (ASE), LV and right ventricular (RV) sphericity index (SI) and direction of flow in the aortic isthmus, as determined by Doppler, were measured. RESULTS: With maternal hyperoxygenation, mean ± SD ASE decreased (0.76 ± 0.17 before maternal hyperoxygenation vs 0.53 ± 0.23 after maternal hyperoxygenation; P < 0.01), consistent with increased pulmonary venous return, LV-SI increased (0.29 ± 0.06 vs 0.42 ± 0.06; P < 0.001), indicating increased LV filling, and the direction of aortic isthmus flow changed from retrograde in all cases prior to maternal hyperoxygenation to antegrade in 10 and to bidirectional in two. RV-SI remained unchanged (0.53 ± 0.13 vs 0.52 ± 0.10; P = 0.7). CONCLUSIONS: In cases of AAS, short-term maternal hyperoxygenation increases fetal pulmonary venous return, substantially alters LV geometry and promotes antegrade flow in the aortic isthmus. This demonstrates proof-of-concept that maternal hyperoxygenation can improve filling of the left side of the fetal heart in AAS.

Oxygen-participated electrochemistry of new lithium-rich layered oxides Li3MRuO5 (M = Mn, Fe).

We describe the synthesis, crystal structure and lithium deinsertion-insertion electrochemistry of two new lithium-rich layered oxides, Li3MRuO5 (M = Mn, Fe), related to rock salt based Li2MnO3 and LiCoO2. The Li3MnRuO5 oxide adopts a structure related to Li2MnO3 (C2/m) where Li and (Li0.2Mn0.4Ru0.4) layers alternate along the c-axis, while the Li3FeRuO5 oxide adopts a near-perfect LiCoO2 (R3[combining macron]m) structure where Li and (Li0.2Fe0.4Ru0.4) layers are stacked alternately. Magnetic measurements indicate for Li3MnRuO5 the presence of Mn(3+) and low spin configuration for Ru(4+) where the itinerant electrons occupy a π*-band. The onset of a net maximum in the χ vs. T plot at 9.5 K and the negative value of the Weiss constant (θ) of -31.4 K indicate the presence of antiferromagnetic superexchange interactions according to different pathways. Lithium electrochemistry shows a similar behaviour for both oxides and related to the typical behaviour of Li-rich layered oxides where participation of oxide ions in the electrochemical processes is usually found. A long first charge process with capacities of 240 mA h g(-1) (2.3 Li per f.u.) and 144 mA h g(-1) (1.38 Li per f.u.) is observed for Li3MnRuO5 and Li3FeRuO5, respectively. An initial sloping region (OCV to ca. 4.1 V) is followed by a long plateau (ca. 4.3 V). Further discharge-charge cycling points to partial reversibility (ca. 160 mA h g(-1) and 45 mA h g(-1) for Mn and Fe, respectively). Nevertheless, just after a few cycles, cell failure is observed. X-ray photoelectron spectroscopy (XPS) characterisation of both pristine and electrochemically oxidized Li3MRuO5 reveals that in the Li3MnRuO5 oxide, Mn(3+) and Ru(4+) are partially oxidized to Mn(4+) and Ru(5+) in the sloping region at low voltage, while in the long plateau, O(2-) is also oxidized. Oxygen release likely occurs which may be the cause for failure of cells upon cycling. Interestingly, some other Li-rich layered oxides have been reported to cycle acceptably even with the participation of the O(2-) ligand in the reversible redox processes. In the Li3FeRuO5 oxide, the oxidation process appears to affect only Ru (4+ to 5+ in the sloping region) and O(2-) (plateau) while Fe seems to retain its 3+ state.

Eosinophilic annular erythema: successful response to ultraviolet B therapy.

Eosinophilic annular erythema (EAE) is a rare and relatively newly described eosinophil-rich dermatosis. Debate still exists as to whether it represent a subtype of Well syndrome or a separate disease entity. We report an 8-year-old boy with a 4-year history of recurrent, asymptomatic annular lesions, which were diagnosed after clincopathological correlation as EAE. This condition usually runs a relapsing and remitting course with resistance to multiple treatments. Prednisolone and hydroxychloroquine have been reported as successful but the response to these was limited in this case. Complete resolution occurred after treatment with ultraviolet B (UVB) therapy. To our knowledge, this is the first report of a favourable response of EAE to such therapy.

Clinical significance of small airway obstruction markers in patients with asthma.

BACKGROUND: The role of small airway obstruction in the clinical expression of asthma is incompletely understood. OBJECTIVE: We tested the hypotheses that markers of small airway obstruction are associated with (i) increased asthma severity, (ii) impaired asthma control and quality of life and (iii) frequent exacerbations. METHODS: Seventy-four adults with asthma and 18 healthy control subjects underwent impulse oscillometry (IOS), multiple breath inert gas washout (MBW), body plethysmography, single-breath determination of carbon monoxide uptake and spirometry. Patients completed the six-point Asthma Control Questionnaire (ACQ-6) and standardized Asthma Quality of Life Questionnaire [AQLQ(S)]. Asthma severity was classified according to the Global Initiative for Asthma (GINA) treatment steps. RESULTS: The putative small airway obstruction markers Sacin , resistance at 5 Hz minus resistance at 20 Hz (R5-R20) and reactance area (AX) were not independently associated with asthma severity, control, quality of life or exacerbations. In contrast, markers of total (R5) and mean airway resistance of large and small airways (R20) were significantly higher in the severe asthma group compared with the mild-moderate group (0.47 vs. 0.37, P < 0.05 for R5; 0.39 vs. 0.31, P < 0.01 for R20). The strongest independent contributors to ACQ-6 score were R20 and forced expiratory volume in one second (% pred.), and the strongest independent contributors to AQLQ(S) score were R20 and forced vital capacity (% pred.). A history of one or more exacerbations within the previous year was independently associated with R20. CONCLUSIONS AND CLINICAL RELEVANCE: Previously reported markers of small airway obstruction do not appear to be independently associated with asthma disease expression. In contrast, the IOS parameter R20, a marker of mean airway resistance of both large and small airways, appears to have independent clinical significance. These observations require confirmation in prospective longitudinal studies.

Optimising peak energy reduction in networks of buildings.

Buildings are amongst the world's largest energy consumers and simultaneous peaks in demand from networks of buildings can decrease electricity system stability. Current mitigation measures either entail wasteful supply-side over-specification or complex centralised demand-side control. Hence, a simple schema is developed for decentralised, self-organising building-to-building load coordination that requires very little information exchange and no top-down management-analogous to other complex systems with short range interactions, such as coordination between flocks of birds or synchronisation in fireflies. Numerical and experimental results reveal that a high degree of peak flattening can be achieved using surprisingly small load-coordination networks. The optimum reductions achieved by the simple schema can outperform existing techniques, giving substantial peak-reductions as well as being remarkably robust to changes in other system parameters such as the interaction network topology. This not only demonstrates that significant reductions in network peaks are achievable using remarkably simple control systems but also reveals interesting theoretical results and new insights which will be of great interest to the complexity and network science communities.

Addition of nisin to high-viscosity glass-ionomer cement: a comparative in vitro study on antibacterial and physical properties.

PURPOSE: Nisin is a lantibiotic effective against Gram-positive microorganisms such as Streptococcus mutans. The study aimed to determine the effect of the addition of nisin to high-viscosity glass-ionomer cement (HVGIC) on its antibacterial activity, setting time, surface microhardness, and compressive strength. METHODS: 1 and 3% w/w nisin were added to HVGIC before mixing. Unmodified HVGIC was the control. Agar disc diffusion, direct contact test, and scanning electron microscopy (SEM) analysis were used to evaluate antibacterial activity against S. mutans. Setting time, surface microhardness, and compressive strength were measured using Gilmore needle apparatus, digital microhardness tester, and universal testing machine, respectively. Statistical analysis included Student's t test, one-way ANOVA with Tamhane's post hoc test, and repeated-measures ANOVA. RESULTS: As evidenced by the agar disc diffusion (p < 0.001), direct contact tests (p = 0.025), and SEM analysis of the S. mutans cell count and cell surface area (p = 0.049 and 0.003), 3% nisin had the strongest antibacterial activity. There was a dose-dependent increase in setting time (p = 0.005) and surface microhardness (p = 0.006), with no significant difference in compressive strength compared to control. CONCLUSION: The addition of 3% nisin to HVGIC enhances the antibacterial action against S. mutans and surface microhardness without adversely affecting setting time and compressive strength.

Implementing teleophthalmology services to improve cost-effectiveness of the national eye care system.

BACKGROUND AND PURPOSE: Optometrist-assisted and teleophthalmology-enabled referral pathway (OTRP) for community optometry referrals has the potential to improve the capacity and efficiency of eye care delivery systems through risk stratification and limiting the number of improved referrals. This study investigates the expected future costs and benefits of implementing OTRP under various possible organizational set-ups relevant to a Danish context. METHODS: A decision-analytic model (decision tree) with a one-year time horizon was constructed to portray alternative future patient referral pathways for people examined in optometry stores for suspected ocular posterior segment eye disease. The main outcomes were total healthcare costs per patient, average waiting time from eye examination in store until the start of treatment or end of referral pathway, and quality-adjusted life-years (QALY) gained. The economic evaluation compares the general ophthalmologist referral pathway (GO-RP) with a potential reimbursement model for the optometrist-assisted teleophthalmology referral pathways (R-OTRP) and a procurement model for the optometrist-assisted teleophthalmology referral pathways (P-OTRP). RESULTS: The cost per individual with suspected ocular posterior segment eye disease was estimated to be £116 for GO-RP and £75 and £94 for P-OTRP and R-OTRP respectively. The average waiting time for diagnosis or end of referral pathway was 25 weeks for GO-RP and 5.8 and 5.7 for P-OTPR and R-OTPR respectively. QALY gain was 0.15 for P-OTRP/R-OTRP compared to 0.06 for GO-RP. CONCLUSION: OTRP is effective in reducing unnecessary referrals and waiting times, increasing patients' HRQoL, and decreasing the costs of diagnosing individuals with suspected ocular posterior segment eye disease.

Exploring the color of transition metal ions in irregular coordination geometries: new colored inorganic oxides based on the spiroffite structure, Zn(2-x)M(x)Te3O8 (M = Co, Ni, Cu).

We describe the synthesis, crystal structures, and optical absorption spectra of transition metal-substituted spiroffite derivatives, Zn(2-x)M(x)Te3O8 (M(II) = Co, Ni, Cu; 0 < x ≤ 1.0). The oxides are readily synthesized by solid state reaction of stoichiometric mixtures of the constituent binaries at 620 °C. Reitveld refinement of the crystal structures from powder X-ray diffraction (XRD) data shows that the Zn/MO6 octahedra are strongly distorted, as in the parent Zn2Te3O8 structure, consisting of five relatively short Zn/M(II)-O bonds (1.898-2.236 Å) and one longer Zn/M(II)-O bond (2.356-2.519 Å). We have interpreted the unique colors and the optical absorption/diffuse reflectance spectra of Zn(2-x)M(x)Te3O8 in the visible, in terms of the observed/irregular coordination geometry of the Zn/M(II)-O chromophores. We could not however prepare the fully substituted M2Te3O8 (M(II) = Co, Ni, Cu) by the direct solid state reaction method. Density Functional Theory (DFT) modeling of the electronic structure of both the parent and the transition metal substituted derivatives provides new insights into the bonding and the role of transition metals toward the origin of color in these materials. We believe that transition metal substituted spiroffites Zn(2-x)M(x)Te3O8 reported here suggest new directions for the development of colored inorganic materials/pigments featuring irregular/distorted oxygen coordination polyhedra around transition metal ions.

Type III Monteggia Fracture-dislocation with Radial Nerve Injury in Adults - A Case Report of two Cases.

Introduction: Uncommon complication of Monteggia fracture is associated PIN palsy. The PIN palsy following Monteggia fracture-dislocation is neuropraxias and will recover spontaneously. Case Report: Two cases who were diagnosed as Monteggia fracture-dislocation with PIN palsy and associated superficial branch of radial nerve injury - Power 0/5 and sensations 0/2 were taken up for surgery (open reduction internal fixation of fracture of ulna + closed reduction of radial head). By the end of 7 weeks, both sensory and motor power were fully recovered spontaneously in both the cases. Discussion: Most of the PIN injuries following Monteggia fracture-dislocation are neuropraxias and will recover spontaneously after closed reduction of radial head without any intervention to the nerve. The nerve needs to be intervened if there are no signs of recovery by 3 months. The time frame for the nerve to be intervened remains controversial. Conclusion: In both of our cases, the injury is probably proximal to the terminal division of radial nerve and the injuries were neuropraxias and have recovered spontaneously. Hence, we suggest not exploring the nerve in all cases with Monteggia fracture-dislocation immediately even when there is associated sensory deficit.

A data-driven reduced-order surrogate model for entire elastoplastic simulations applied to representative volume elements.

This contribution discusses surrogate models that emulate the solution field(s) in the entire simulation domain. The surrogate uses the most characteristic modes of the solution field(s), in combination with neural networks to emulate the coefficients of each mode. This type of surrogate is well known to rapidly emulate flow simulations, but rather new for simulations of elastoplastic solids. The surrogate avoids the iterative process of constructing and solving the linearized governing equations of rate-independent elastoplasticity, as necessary for direct numerical simulations or (hyper-)reduced-order-models. Instead, the new plastic variables are computed only once per increment, resulting in substantial time savings. The surrogate uses a recurrent neural network to treat the path dependency of rate-independent elastoplasticity within the neural network itself. Because only a few of these surrogates have been developed for elastoplastic simulations, their potential and limitations are not yet well studied. The aim of this contribution is to shed more light on their numerical capabilities in the context of elastoplasticity. Although more widely applicable, the investigation focuses on a representative volume element, because these surrogates have the ability to both emulate the macroscale stress-deformation relation (which drives the multiscale simulation), as well as to recover all microstructural quantities within each representative volume element.

A novel application of a bioactive material as a pit and fissure sealant: in vitro pilot study evaluating the sealing ability and penetration.

PURPOSE: To compare the sealing ability and penetration of a bioactive material used as pit and fissure sealant to those of glass ionomer sealant. METHODS: This was an in vitro experimental study conducted on 20 permanent teeth. For Group I of ten teeth, ACTIVA BioACTIVE-Base/Liner was applied as a sealant on pits and fissures, and the remaining ten teeth of Group II were sealed using glass ionomer cement. After thermocycling, the apex of the teeth was sealed using composite resin and they were immersed in 1% methylene blue solution, buffered at pH 7 for 24 h. Longitudinal sections were obtained from each tooth for evaluating the sealing ability and penetration, using a binocular light microscope at 4 × magnification. The obtained data were subjected to analysis using the Chi-square test and independent t test. RESULTS: The comparison of the sealing ability and sealant penetration, between the two groups, showed statistically no significant difference (p = 0.104 and p = 1.0, respectively). CONCLUSION: Bioactive material as a pit and fissure sealant, performed on par with glass ionomer sealant in terms of tested properties like sealing ability and penetration.

Post market surveillance registry (PIONEER) of the Yukon Choice PC-Elite Coronary Stent System for percutaneous coronary intervention in Indian acute coronary syndrome population.

AIM: The aim of this study was to assess the safety and efficacy profile of a newer generation biodegradable DES, the Yukon Choice PC Elite with a temperature controlling mechanism, in patients with acute coronary syndrome (ACS). METHODS: This prospective multi-center study (PIONEER Registry) was conducted in an Indian ACS population, therefore providing data in real world clinical practice. Patients with ACS underwent DES implantation in de novo native-vessel coronary lesions with the Yukon Choice PC Elite biodegradable polymer DES and were followed up for a year. RESULTS: A total 999 patients were evaluated. The majority of patients were male (79.2%). A total of 6.7% of the patients had a history of prior myocardial infarction (MI) and 2.7% of patients had a history of previous coronary artery bypass graft. The clinical presentations of the patients included: unstable angina pectoris (UA) (46.4%), ST-segment elevation MI (STEMI) (38.1%), and Non-ST-segment elevation MI (NSTEMI) (15.4%). Implantation of the device was successful in 99.9% of cases. The median stent length and stent size were 21.0 mm (Range: 8.0-40.0 mm) and 2.8 mm (Range 2.0-4.0 mm), respectively. Through to one-year clinical follow-up after percutaneous coronary intervention, all-cause death occurred in 4 of 999 patients (Crude Percentage: 0.4%). Cardiac death, MI, TLR, and stent thrombosis were occurred in 1 (0.1%), 8 (0.8%), 12 (1.2%) and 1 (0.1%) patients, respectively. CONCLUSION: The results of this post marketing surveillance registry suggest favorable safety and efficacy outcomes associated with the Yukon Choice PC Elite biodegradable DES in a real world Indian ACS population.

Awareness and perception of an Indian dental professional in context to the process and their role in disaster victim identification as a taskmaster.

Forensic odontology is a young area in India. However, it has been used as an integral component in a various medicolegal cases in India. However, the involvement of a dentist in mass disasters still needs to be well recognized. The role of the dentists in any unforeseen circumstances is to contribute as an adjunct hand in Disaster Victim Identification (DVI) which is in an emergent stage in India. This study aimed to assess an Indian dental professional's knowledge and awareness of their role in DVI. A pre-tested, self-administered anonymous questionnaire consisting of 6 open-ended and 14 close-ended questions was mailed to the participants. A total of 441 responses were recorded. The study indicated adequate knowledge and awareness among dental practitioners. Conversely, only a handful of people had first-hand autopsy experience. Thus, to supplement the skills needed to work at ground zero, it is recommended to develop hands-on training programs for dentists in each state of India. Also, creating a pool of experts in each state of India can strengthen the task force.