EMBRACE (Empowering Medical students' skills in BReaking bAd news with Compassion and Empathy) module improves the skills of undergraduate medical students in effectively breaking the bad news: a case-control study.

Effective communication skills are pivotal in health care, particularly when conveying distressing information to patients and their families. However, medical education still lacks the adoption of a universal model that can be incorporated into the curricula to train and assess students in effectively communicating with patients. This study aims to assess the impact of training undergraduate medical students to deliver bad news effectively using the Empowering Medical students' skills in BReaking bAd news with Compassion and Empathy (EMBRACE) module. This randomized case-control study involved medical students from the first, second, and third professional years (study group, n = 75; control group, n = 75). For the study group, the EMBRACE modules were distributed. Then, a 1-hour training session on effectively delivering bad news was followed by a multiple-choice question test and objective structured clinical examination with response, interpretation, and communication skills stations. Participants' feedback was obtained on a five-point Likert scale. There was a highly significant improvement in knowledge and skills among the study group compared to controls with a P value less than 0.0001. Of the participants, 98.76% perceived that the training equipped them with practical skills, and 98.77% felt that the facilitator had demonstrated the steps of delivering bad news clearly and effectively. Only 4.44% of participants were confident in effectively interacting with patients before the session, and an overwhelming 81.11% gained confidence in their communication skills after the training. With demonstrated significant improvement in knowledge and skills, this study supports the adoption of EMBRACE modules in undergraduate medical education, ultimately improving patient experiences, doctor-patient relationships, and health outcomes.NEW & NOTEWORTHY The Empowering Medical students' skills in BReaking bAd news with Compassion and Empathy (EMBRACE) module is noteworthy for its holistic approach to training medical students in the delicate art of delivering distressing news to patients. It not only incorporates the evidence-based setting, perception, invitation, knowledge, emotions, and strategy (SPIKES) method but also distinguishes itself by providing real-life conversation examples and self-assessment cases, which make the training highly relatable and practical for students to actively engage in their learning and personal development.

#Ihaveembraced: a pilot cross-sectional naturalistic evaluation of the documentary film Embrace and its potential associations with body image in adult women.

BACKGROUND: The aim of this project was to examine the qualitative responses of adult women who had seen the feature-length documentary film 'Embrace'. In addition, to establish the potential for the documentary to be used as an intervention to improve adult body image, a naturalistic study was conducted to examine whether any differences on measures of body image were apparent among women who had, versus those who had not, seen the film. METHOD: Participants were 1429 women aged 18-77 who were members of the Facebook group 'Body Image Movement' facilitated by Taryn Brumfitt, who also directed the documentary Embrace. Participants completed a cross-sectional online questionnaire regarding whether they had seen the film, their perceptions of the impact of the film on their lives and body image, and a range of standardized scales measuring psychological wellbeing. RESULTS: Overall, the majority of participants had seen the film (n = 1053, 73.7%). Qualitative analysis of open-ended data asking about the changes participants made after viewing the film revealed that a large proportion (44.1%) felt they had higher levels of body appreciation and body confidence, many reported engaging less in dieting (19.6%), and some reported lowered disordered eating (2.8%), since seeing Embrace. Women who had seen the film also reported significantly higher levels of body appreciation (Body Appreciation Scale; medium effect size), and significantly lower levels of internalization of body ideals, self-objectification, body shame, and dietary restraint, than women who had not seen the film. CONCLUSIONS: Adult women reported numerous positive responses to their viewing of the film. Future experimental research should explore the efficacy of Embrace as a brief and engaging intervention for improving body image in adult women.

Integrated care systems and nurse leadership.

There will be significant changes to the way in which primary and community health services are provided in the wake of the NHS Long Term Plan published in January 2019. Community nurses are already preparing themselves for these changes by exploring models of care that are patient-centred and link to neighbourhood, place and system levels. This article discusses two examples of such models of care, the Buurtzorg and Embrace model, both from the Netherlands. Styles of leadership and associated development, both within nursing and on a multi-professional basis will be crucial to ensure success. This article outlines Alban-Metcalfe's engaging transformational leadership model as a potential platform to move to flatter, more diverse teams and collective leadership.

Eribulin therapy for the treatment of patients with advanced soft tissue sarcoma.

Eribulin is a structurally simplified, synthetic macrocyclic ketone analog of halichondrin B, which is a natural, polyether macrolide derived from marine sponges. Eribulin exerts its cytotoxicity by its unique microtubule dynamics inhibitory action. Eribulin was approved in 2010 by the US FDA as a third-line therapy for metastatic breast cancer patients previously treated with an anthracycline and a taxane. In 2016, it was approved for treatment of metastatic liposarcoma for patients who have progressed with anthracycline treatment. In this article, we review the pharmacokinetics, mechanism of action of eribulin with focus on preclinical and clinical data in sarcoma and also the role of miRNAs in soft tissue sarcomas.

Stereospecific Winding of Polycyclic Aromatic Hydrocarbons into Trinacria Propellers.

The stereospecific trimerization of enantiomerically pure binaphthols with hexakis(bromomethyl)benzene gives access in one step to enantiomerically pure molecular propellers, in which three binaphthyl rings are held together with dioxecine rings. X-ray diffraction analysis revealed that three out the six naphthyl moieties are folded in a (EF)3 -type arrangement held by three intramolecular C-H⋅⋅⋅π interactions. This slips outward the three remaining naphthyl rings in a blade-like fashion, just like in three-folded propeller components. This peculiar conformation shows striking similarity to the mythological Sicilian symbol of Trinacria, from which the name "trinacria propeller" derives. The propeller conformation is also preserved in chlorinated solutions, as displayed by the presence of a peak at 4.7 ppm typical of an aromatic proton resonance engaged in a C-H⋅⋅⋅π interaction. The denaturation of the propeller-like conformation is obtained at high temperature, corresponding to activation energy for the ring inversion of ca. 18.2 kcal mol-1 . Notably, halide-functionalized molecular propellers exposing I-atoms at the leading and trailing edges could be prepared stereo- and regiospecifically by choosing the relevant iodo-bearing BINOL derivative.

Embraces are lateralized in spider monkeys (Ateles fusciceps rufiventris).

Side biases observed in behavior are thought to reflect underlying asymmetric brain function or hemispheric specialization. Previous work in multiple species identified left side biases (associated with the right hemisphere) for processing social behavior. In highly social species such as primates, many behaviors may be categorized as social, yet differences between such behaviors have not been examined as a test of asymmetric brain function. Using Colombian spider monkeys (Ateles fusciceps rufiventris), we observed lateral positioning during two types of behaviors widely categorized as social affiliative: embracing and grooming, and identified a left bias for embracing, but not grooming. Our findings partially support prior research in hemispheric specialization, but suggest that there may be differences between social behaviors that drive specialization. We discuss these results in light of current theory on hemispheric specialization and highlight differences between embracing and grooming.

Comparison of Microleakage of Class V Cavities restored with the Embrace WetBond Class V Composite Resin and Conventional Opallis Composite Resin.

PURPOSE: This study was undertaken to compare the micro-leakage of class V cavities restored with the newly introduced Embrace WetBond class V (EWC) composite resin and conventional Opallis composite resin. MATERIALS AND METHODS: In this in vitro study, class V cavities were prepared on 30 extracted bovine incisors, with the gingival floor and the coronal margin of the cavities 1 mm apical and coronal to the cementoenamel junction (CEJ) respectively. The cavities measured 3 mm in length, 2 mm in width, and 1.5 mm in depth. The teeth were randomly divided into two groups. In group I, the cavities were restored with Opallis composite resin in association with ExciTE adhesive system (total-etch); in group II, the EWC composite resin was used for restorations. After 500 thermocycling procedures, the teeth were immersed in 0.5% fuchsin solution for 24 hours. Then, the samples were placed within a polyester model and sectioned in the buccolingual direction. The samples were evaluated under a stereomicroscope at ×30 for the penetration of dye. The enamel and dentin margins were evaluated separately. To test ordinal results, we used nonparametric statistical methods. To find out whether each independent composite groups I and II came from the same populations, we used Mann-Whitney U test and to compare two related samples' coronal margin and gingival margin, Wilcoxon signed-rank test was used. RESULTS: There was significantly more microleakage in group II at both the enamel and dentin margins (coronal margin: p = 0.04; gingival margin: p = 0.21). In both groups, microleakage at gingival margins was significantly higher than that at coronal margins (group I: p = 0.008; group II: p = 0.26). CONCLUSION: Despite the high speed and the short process of restoration with Embrace WetBond, it is not a reliable restorative material for class V cavities due to its inadequate marginal seal.

Eribulin in Cancer Treatment.

Halichondrin B is a complex, natural, polyether macrolide derived from marine sponges. Eribulin is a structurally-simplified, synthetic, macrocyclic ketone analogue of Halichondrin B. Eribulin was approved by United States Food and Drug Administration in 2010 as a third-line therapy for metastatic breast cancer patients who have previously been treated with an anthracycline and a taxane. It has a unique microtubule dynamics inhibitory action. Phase III studies have either been completed or are currently ongoing in breast cancer, soft tissue sarcoma, and non-small cell lung cancer. Phase I and II studies in multiple cancers and various combinations are currently ongoing. This article reviews the available information on eribulin with respect to its clinical pharmacology, pharmacokinetics, pharmacodynamics, mechanism of action, metabolism, preclinical studies, and with special focus on clinical trials.

In vitro Investigation of Resin Tag Lengths of Three Commercially Available Pit and Fissure Sealants.

Aim: The aim of this in vitro study was to perform a comparative evaluation of the length of resin tags produced by three different types of pit and fissure sealants (Embrace WetBond, Helioseal Clear, and Fuji VII) using scanning electron microscopy. Materials and Methods: Thirty extracted mandibular premolars were randomly divided into three groups of ten. Each group was treated with one of the sealants - Embrace WetBond, Helioseal Clear, or Fuji VII. Following cleaning and preparation, the sealants were applied according to the manufacturer's instructions. Teeth were then sectioned and prepared for SEM investigation, and the length of resin tags was measured. Results: Scanning electron microscopy revealed Embrace WetBond produced significantly longer resin tags than Helioseal Clear and Fuji VII. Conclusion: The study concludes that Embrace WetBond sealant exhibited the longest resin tags, which may suggest a stronger mechanical bond to enamel.

Comparison of the Effect of Different Bonding Agents on the Microleakage of Two Hydrophilic Pit and Fissure Sealants: An Ex Vivo Study.

Aim: To compare the impact of fifth- and seventh-generation bonding agents on the microleakage between Embrace WetBond sealants and Ionoseal. Materials and methods: Forty extracted human premolar teeth were used for the study and grouped according to different sealants and bonding agents-group I: Embrace WetBond sealant with fifth-generation bonding agent; group II: Embrace WetBond sealant with seventh-generation bonding agent; group III: Ionoseal with fifth-generation bonding agent; group IV: Ionoseal with seventh-generation bonding agent. For microleakage evaluation, all the teeth were subjected to invasive sealant placement using the respective sealant materials in combination with bonding agents as specified. The treated teeth were stored at 37°C for 24 hours and then thermocycled for 100 cycles at temperatures of 5°C and 55°C with a dwell time of 30 seconds. In order to assess microleakage, the samples were immersed in 0.2% methylene blue dye for 24 hours, then sectioned in buccolingual direction, and evaluated under stereomicroscope. Results: The mean microleakage scores in group III were highest at 0.90 ± 0.57, while the least was in group IV at 0.30 ± 0.68, indicating that Ionoseal with seventh-generation bonding agent was the most effective. However, when the mean microleakage scores of the four groups were compared using Kruskal-Wallis test, it indicated that the differences were not statistically significant. How to cite this article: V R, P P, A A, et al. Comparison of the Effect of Different Bonding Agents on the Microleakage of Two Hydrophilic Pit and Fissure Sealants: An Ex Vivo Study. Int J Clin Pediatr Dent 2024;17(3):270-273.

In vitro analysis of material micro-leakage in pit and fissure sealants.

A preferable choice of material offers superior resistance against micro-leakage for clinical applications in preventing dental caries in pits and fissures is of interest. A total of 45 extracted human premolars were cleaned, stored in a saline solution, and randomly divided into three groups, each intended for treatment with one of the sealants: Fuzi VII, ClinPro, and Embrace Wetbond. The application of the sealants followed the manufacturers' instructions strictly. The teeth were subjected to thermal cycling to simulate oral conditions. Marginal micro-leakage was then assessed by dye penetration method using a 0.5% methylene blue dye. Teeth were sectioned, and dye penetration was measured under a stereomicroscope. The results showed that all the tested materials exhibited some degree of micro-leakage. Within the limitations of this In vitro study, it was concluded that Embrace Wetbond exhibited superior performance in terms of minimizing marginal micro-leakage among the tested pit and fissure sealants.

Comparative Evaluation of Sealing Ability of Moisture-tolerant Sealant and Glass Ionomer Sealant Using Stereomicroscope: An In Vitro Study.

Introduction/background: The preventive benefits of pit and fissure sealants rely on their retention and sealing ability. The drawback of the conventional pit and fissure sealant is its poor retention due to the presence of moisture. Among the numerous pit and fissure sealants available, newer hydrophilic sealants are ideal for children. This study evaluates and compares the sealing ability of hydrophilic sealant Embrace WetBond with conventionally used glass ionomer sealant under a stereomicroscope. Materials and methods: A total of 48 extracted human premolars were randomly divided into two groups (N = 24) and sealed with Embrace WetBond and GC Fuji VII as per manufacturers' instructions. Following thermocycling, the sectioned samples were evaluated for sealant penetration, unfilled space, and total length of fissure under a stereomicroscope at magnifications 2.5×, 4×, and 5×. The values were measured in microns and in various fissure types using the "ImageJ app" to measure the sealant penetrability and sealing ability. The data recorded were statistically evaluated. Results: The penetrability of moisture-tolerant sealant was better (87.8 ± 10.7) compared to that of glass ionomer sealant (73.8 ± 15.5) (p = 0.002). Among the samples, U-type fissure patterns displayed greater penetrability (94.2 ± 6.2), whereas IK-type fissures revealed the lowest degree of penetrability (67.5 ± 7.3). Conclusion: Embrace WetBond is better than glass ionomer sealant with respect to penetrability and sealing ability under stereomicroscope hence recommended as a better sealant for pediatric clinical practice. How to cite this article: Priscilla S, Shivashankarappa PG, Mohandoss S, et al. Comparative Evaluation of Sealing Ability of Moisture-tolerant Sealant and Glass Ionomer Sealant Using Stereomicroscope: An In Vitro Study. Int J Clin Pediatr Dent 2023;16(S-1):S67-S71.

Assessment of Embrace-WetBond and Fissurit F Pit and Fissure Sealants' Marginal Sealing Abilities.

Objectives: The goal of the current research was to assess marginal sealing abilities of 2 commercial pit and fissure sealants. Materials and Methods: A total of 30 premolar teeth were equally classified into 2 groups: Group A-application of Embrace-WetBond sealant and Group B-application of Fissurit F, Voco sealant. After sealant placement, samples were preserved in artificial saliva for 48 hours prior to thermocycling. Later, samples were submerged for 24 hours in a 2% methylene blue solution. The amount of microleakage based on the quantity of dye penetration at interface between the tooth substance and sealant was compared under an optical stereomicroscope. The obtained data were statistically analysed for the dye penetration scores in both groups. Result: It was observed that 8 samples from Group A (53%) had no dye penetration (Grade 0), whereas 4 samples from Group B (26%) showed Grade 0 penetration. In 5 out of 15 samples (33%) from Group B, the dye penetration was the greatest (Grade 3; P = 0.012). Conclusion: It was concluded that Embrace-WetBond had lesser microleakage compared to group 2-Fissurit F, Voco sealant.

A Novel Flexible Fixation Method for Syndesmotic Injury.

BACKGROUND: This study aims to evaluate the results and the safety of a novel fixation method we developed for syndesmosis injuries that we call the "embrace" technique. METHODS: Between March 2018 and October 2020, a total of 67 patients with ankle fractures and syndesmotic injuries underwent syndesmosis fixation with the embrace technique at our institute. Plain radiographs and computed tomographic (CT) scans were obtained preoperatively. Postoperative radiographic assessment included anteroposterior (AP) and lateral radiographs and CT scans of both ankles. Additionally, the American Orthopaedic Foot & Ankle Society (AOFAS) Ankle-Hindfoot Score, Olerud-Molander Ankle Score, and visual analog scale (VAS) score were used for postoperative assessment. RESULTS: The mean age was 27.6 ± 10.9 (range, 14-56) years. The mean follow-up time was 30.3 ± 6.2 (range, 24-48) months. There were no malreductions indicated by any CT parameter except fibular rotation in a postoperative comparison between 2 sides. We found significant preoperative-postoperative changes in anterior difference, posterior difference, and fibular rotation but no significant preoperative-postoperative difference in fibular translation. There was no significant postoperative difference between the affected-side and normal-side measurements of any parameter. Complications included delayed wound healing, lateral pain because of wire knot irritation (11.9%), and medial fiber wire irritation (7.5%). The mean AOFAS, Olerud-Molander, and VAS scores at the last follow-up were 94.4 ± 6.8 (range, 84-100), 95.4 ± 6.1 (range, 80-100), and 0.68 ± 1.0 (range, 0-3) points, respectively. CONCLUSION: In our cohort, this novel technique proved to be an effective method for syndesmosis fixation in patients with ankle fractures associated with very good radiologic and patient-reported outcomes. LEVEL OF EVIDENCE: Level IV, case series.

Safety and efficacy of single insertion accelerated MR-image guided brachytherapy following chemo-radiation in locally advanced cervix cancer: modifying our EMBRACE during the COVID pandemic.

BACKGROUND: Utero-vaginal brachytherapy (BT) is an irreplaceable care component for the curative treatment of locally advanced cervix cancer (LACC). Magnetic Resonance Imaging (MRI)-image guided adaptive BT (IGABT) using the GYN-GEC-ESTRO EMBRACE guidelines is the international care standard. Usually following chemo-radiation therapy (CRT), IGABT has high proven utility in LACC but requires significant health system resources. Timely access was disrupted by the COVID-19 pandemic which challenged us to re-design our established IGABT care pathway. METHODS: From April 2020 consecutive patients with LACC were enrolled after CRT in a single arm exploratory non-inferiority study of a modified IGABT (mIGABT) protocol. This delivered an iso-effective IGABT dose (39.3 Gy: EQD2: α/ß10Gy concept) over a 24-h period during a single overnight hospitalisation. RESULTS: Fourteen LACC patients received mIGABT from April 2020 to March 2022. Median age was 62.5 years (37-82 years). LACC histology was primary squamous (9/14) or adeno-carcinoma (5/14). International Federation of Gynaecology and Obstetrics (FIGO) 2018 stages ranged from IB1/2 (N = 3), IIA1/IIB (5), IIIB (2), IIIC1/2 (4) with mean ± standard deviation (SD) gross tumour volume-at-diagnosis (GTV_D) of 37.7 cc ± 71.6 cc. All patients achieved complete metabolic, clinical, and cytologic cancer response with CRT and IGABT. High-risk HPV was cleared by 6-months. Complete MRI-defined cancer response before mIGABT (GTV_Fx1) was seen in 77% of cases (10/13). Only two women developed metastatic disease and one died at 12-months; 13 patients were alive without cancer at mean 20.3 ± 7.2 months follow-up. Actuarial 2-year overall survival was 93%. Compared with our pre-COVID IGABT program, overall mIGABT cost-saving in this cohort was USD 22,866. Prescribed dose covered at least 90% (D90) of the entire cervix and any residual cancer at time of BT (HRCTV_D90: high-risk clinical target volume) with 3-fractions of 8.5 Gy delivered over 24-h (22.8 ± 1.7 h). Total treatment time including CRT was 38 days. The mIGABT schedule was well tolerated and the entire cohort met EMBRACE recommended (EQD2: α/ß10Gy) combined HRCTV_D90 coverage of 87.5 ± 3.7 Gy. Similarly, organ-at-risk (OAR) median: interquartile range D2cc constraints (EQD2: α/ß3Gy) were EMBRACE compliant: bladder (65.9 Gy: 58.4-72.5 Gy), rectum (59.1 Gy: 55.7-61.8 Gy), and sigmoid colon (54.6 Gy: 50.3-58.9 Gy). ICRU recto-vaginal point dose was significantly higher (75.7 Gy) in our only case of severe (G4) pelvic toxicity. CONCLUSIONS: This study demonstrated the utility of mIGABT and VMAT CRT in a small cohort with LACC. Loco-regional control was achieved in all cases with minimal emergent toxicity. Single insertion mIGABT was logistically efficient, cost-saving, and patient-centric during the COVID-19 pandemic.

Clinical Evaluation of Retention of Hydrophilic and Hydrophobic Pit and Fissure Sealants in Permanent First Molars: An 18 Months Follow-up: Randomized Controlled Trial.

Introduction: Deep pits and fissures are more prone to caries development due to their complex morphological anatomy. Preventive measures, such as pit and fissure sealants, can help in the reduction of dental caries. Conventional sealants being hydrophobic in nature, require isolation. Sealants which are hydrophilic have been introduced as an alternative where isolation is difficult to achieve. Aim: To compare and evaluate the retention and marginal integrity of hydrophilic pit and fissure sealant (Embrace WetBond) with hydrophobic pit and fissure sealant (Clinpro) in permanent first molars. Materials and methods: Sealants were applied randomly using the split-mouth design technique on 80 permanent first molars in children aged between 6 and 9 years and evaluation was done at 3, 6, 9, and 18 months. Results: The difference in retention rates between the groups was not significant using the Chi-squared test, though the WetBond group exhibited better results with 40% complete retention at the end of 18 months while in the Clinpro group, it was 37.50%. The marginal integrity in both the sealant groups was also found to be statistically insignificant. Caries incidence was found to be slightly higher in the Clinpro group. Conclusion: The clinical performance of Embrace WetBond was better when compared to Clinpro because of its moisture-tolerance capacity. Embrace Wetbond pit and fissure sealant can be the choice of material in cases where moisture control is a challenging issue. How to cite this article: Gyati O, Jain M, Sogi S, et al. Clinical Evaluation of Retention of Hydrophilic and Hydrophobic Pit and Fissure Sealants in Permanent First Molars: An 18 Months follow-up: Randomized Controlled Trial. Int J Clin Pediatr Dent 2023;16(2):350-356.

A 1-Tesla MRI system for dedicated brain imaging in the neonatal intensive care unit.

Objective: To assess the feasibility of a point-of-care 1-Tesla MRI for identification of intracranial pathologies within neonatal intensive care units (NICUs). Methods: Clinical findings and point-of-care 1-Tesla MRI imaging findings of NICU patients (1/2021 to 6/2022) were evaluated and compared with other imaging modalities when available. Results: A total of 60 infants had point-of-care 1-Tesla MRI; one scan was incompletely terminated due to motion. The average gestational age at scan time was 38.5 ± 2.3 weeks. Transcranial ultrasound (n = 46), 3-Tesla MRI (n = 3), or both (n = 4) were available for comparison in 53 (88%) infants. The most common indications for point-of-care 1-Tesla MRI were term corrected age scan for extremely preterm neonates (born at greater than 28 weeks gestation age, 42%), intraventricular hemorrhage (IVH) follow-up (33%), and suspected hypoxic injury (18%). The point-of-care 1-Tesla scan could identify ischemic lesions in two infants with suspected hypoxic injury, confirmed by follow-up 3-Tesla MRI. Using 3-Tesla MRI, two lesions were identified that were not visualized on point-of-care 1-Tesla scan: (1) punctate parenchymal injury versus microhemorrhage; and (2) small layering IVH in an incomplete point-of-care 1-Tesla MRI with only DWI/ADC series, but detectable on the follow-up 3-Tesla ADC series. However, point-of-care 1-Tesla MRI could identify parenchymal microhemorrhages, which were not visualized on ultrasound. Conclusion: Although limited by field strength, pulse sequences, and patient weight (4.5 kg)/head circumference (38 cm) restrictions, the Embrace® point-of-care 1-Tesla MRI can identify clinically relevant intracranial pathologies in infants within a NICU setting.

A Comparative Evaluation of Shear Bond Strength of Embrace WetbondTM Pit and Fissure Sealant with or without the Use of a Universal Dental Adhesive System [ScotchbondTM Universal Adhesive] Using Different Bonding Protocols: A Multiparametric In Vitro Study.

Aim: To evaluate and compare the shear bond strength (SBS) of Embrace WetBondTM (EWS) Pit and Fissure Sealant (PF sealants) with or without the use of a universal dental adhesive system ScotchbondTM Universal Adhesive (SBU) using different bonding and curing protocols and to assess and compare the mode of failure as determined by visualization of the fractured surfaces of the test specimens after shear testing under an optical microscope at a magnification of 20×. Materials and methods: A total of 85 samples were prepared for testing SBS on enamel on caries-free, extracted permanent human molars. The specimens were randomly divided into five groups based on different bonding and curing protocols. A knife-edge blade in a universal testing machine was used to perform the SBS test with a crosshead speed of 1 mm/minute. Then the mode of failure was assessed. Statistical analysis: Results were analyzed using a one-way analysis of variance with Tukey's post hoc test and Chi-squared test. A probability value 0.05 (p ≤ 0.01) was regarded as significant. Results: ScotchbondTM Universal Adhesive (SBU) in total-etch (TE) mode/etch-and-rinse (ER) mode with individual light curing of the sealant and adhesive showed the highest SBS to enamel (5.40 ± 2.51 MPa). A predominance of cohesive mode of failure was observed for all the test groups. Conclusion: Embrace WetBondTM (EWS) PF sealants with SBU in the ER mode of application, with either curing mode, can be used as an alternative to a conventional technique for sealant placement for improving interfacial bond strength to enhance sealant retention and efficacy. Clinical significance: Embrace WetBondTM (EWS) PF sealants with SBU in the ER mode of application can be used as an alternative to a conventional technique for sealant placement for improving interfacial bond strength. How to cite this article: Swathy SR, Naidu J. A Comparative Evaluation of Shear Bond Strength of Embrace WetbondTM Pit and Fissure Sealant with or without the Use of a Universal Dental Adhesive System [ScotchbondTM Universal Adhesive] Using Different Bonding Protocols: A Multiparametric In Vitro Study. Int J Clin Pediatr Dent 2023;16(1):48-53.

The role of pre-treatment paraaortic surgical staging for cervical cancer in the EMBRACE criteria.

Background: The State-of-the-Art Treatment for Locally Advanced Cervical Cancer (LACC) is Definite Radio-Chemotherapy based on the Image-guided intensity modulated External beam radiochemotherapy and MRI-based adaptive BRAchytherapy (EMBRACE) trial, according to the FIGO staging. This staging is based on clinical examination and imaging studies; however, there are limitations of imaging techniques which may result in adverse events or death due to insufficient or overtreatment. The aim of the study was to evaluate the feasibility and outcomes of surgical staging in LACC prior to radiotherapy (RT) to personalise target volumes for radiotherapy. Methods: From 2008 to 2018, 138 patients with FIGO 2018 stages IB3-IIIC2 cervical cancer underwent a pretherapeutic laparoscopic staging procedure. The pathological diagnosis was compared with the results of preoperative CT scan. Patients were treated with chemoradiotherapy tailored according to the staging results. Results: The mean patient age was 43 years, the mean body mass index was 27 kg/m2; most lesions were squamous cervical cancer (92%). Staging CT scan had a 77% concordance with the histological findings. Sensitivity was 29%, specificity 85%, positive predictive value 21% and negative predictive value 89%. Surgical staging led to change of stage in 24% of cases. Para -aortic dissection led to change the initially planned radiotherapy fields in 47% of the cases. Major complications included involuntary section of the inferior mesenteric artery (IMA) without clinical repercussion, an infected retroperitoneal haematoma and a symptomatic lymphocele requiring laparoscopic drainage. Conclusion: Laparoscopic staging before primary chemoradiation in patients with LACC was feasible, safe and reproducible, allowing reduction of the radiotherapy treatment volumes of patients.

Feasibility of electronic brachytherapy in cervix cancer-A dosimetric comparison of different brachytherapy techniques.

INTRODUCTION: This study analyzes cases in which electronic brachytherapy (eBT) led to acceptable treatment plans in cervical cancer. Findings were compared with dosimetry values obtained in 192Ir-based treatments according to the high-risk clinical target volume (HR-CTV) and the disease stage. MATERIAL AND METHODS: We retrospectively analyzed 48 patients with cervical cancer from two centers. The patients were treated with 192Ir based on MRI. It was possible to use interstitial needles via an Utrecht-type applicator. Dosimetry was simulated using eBT and the parameters D90 and D98 (HR-CTV) and D2cc, D1cc, and D0.1cc (bladder, rectum, and sigmoid colon) were evaluated. The Mann-Whitney U test was used for comparison. The overall cohort of patients was analyzed, as were the sub-cohorts based on stage (FIGO stages I+IIA, IIB and III-IV). Finally, the dosimetry of the eBT plans was evaluated, and the plans obtained were classified as "good", "acceptable", or "poor". RESULTS: Statistically significant differences were found between the eBT and 192Ir plans for D98 (HR-CTV), D1cc and D0.1cc (bladder), and D1cc and D0.1cc (sigmoid colon). A total of 31 cases (64.6%) were considered good, seven (14.6%) were considered acceptable, and 10 (20.8%) were considered poor. For volumes <30 cc, all the plans were good or acceptable; for volumes >30 cc, 54.3% were good, and 71.4% were good or acceptable. By stage, eBT plans for patients with stage IB-IIA disease were good in 100%, whereas those for patients with stage IIB were good in 70.6% and III-IV disease were good in 50%. CONCLUSIONS: eBT provides appropriate dosimetry for treatment of cervical cancer in selected cases.