A new method: measurement of microleakage volume using human, dog and bovine permanent teeth

This study investigates the feasibility of a different new approach to determining the microleakage volume associated with dental restorations (Class V cavity restorated with glass ionomer cement + high copper amalgam) and the relative marginal adaptation deficiency of dog, bovine and human permanent teeth in in vitro conditions. Also researched is the appropriateness of using dog and bovine teeth in in vitro studies rather than human teeth. Our method utilizes the molecular adsorption characteristics of methylene blue. Within the framework of this study, 60 permanent teeth (20 human, 20 dogs and 20 bovine) were used. These groups were evaluated statistically, of which indicated no statistically significant differences (p > 0.05). It was also concluded that this preliminary investigation showed that the new microleakage volume measurement method may be a valuable new technique for the in vitro study of microleakage dynamics around dental restorations

Surgical site infection after gastrointestinal surgery in high-income, middle-income, and low-income countries: a prospective, international, multicentre cohort study

Background: Surgical site infection (SSI) is one of the most common infections associated with health care, but its importance as a global health priority is not fully understood. We quantified the burden of SSI after gastrointestinal surgery in countries in all parts of the world. Methods: This international, prospective, multicentre cohort study included consecutive patients undergoing elective or emergency gastrointestinal resection within 2-week time periods at any health-care facility in any country. Countries with participating centres were stratified into high-income, middle-income, and low-income groups according to the UN's Human Development Index (HDI). Data variables from the GlobalSurg 1 study and other studies that have been found to affect the likelihood of SSI were entered into risk adjustment models. The primary outcome measure was the 30-day SSI incidence (defined by US Centers for Disease Control and Prevention criteria for superficial and deep incisional SSI). Relationships with explanatory variables were examined using Bayesian multilevel logistic regression models. This trial is registered with ClinicalTrials.gov, number NCT02662231. Findings: Between Jan 4, 2016, and July 31, 2016, 13 265 records were submitted for analysis. 12 539 patients from 343 hospitals in 66 countries were included. 7339 (58·5%) patient were from high-HDI countries (193 hospitals in 30 countries), 3918 (31·2%) patients were from middle-HDI countries (82 hospitals in 18 countries), and 1282 (10·2%) patients were from low-HDI countries (68 hospitals in 18 countries). In total, 1538 (12·3%) patients had SSI within 30 days of surgery. The incidence of SSI varied between countries with high (691 [9·4%] of 7339 patients), middle (549 [14·0%] of 3918 patients), and low (298 [23·2%] of 1282) HDI (p < 0·001). The highest SSI incidence in each HDI group was after dirty surgery (102 [17·8%] of 574 patients in high-HDI countries; 74 [31·4%] of 236 patients in middle-HDI countries; 72 [39·8%] of 181 patients in low-HDI countries). Following risk factor adjustment, patients in low-HDI countries were at greatest risk of SSI (adjusted odds ratio 1·60, 95% credible interval 1·05–2·37; p=0·030). 132 (21·6%) of 610 patients with an SSI and a microbiology culture result had an infection that was resistant to the prophylactic antibiotic used. Resistant infections were detected in 49 (16·6%) of 295 patients in high-HDI countries, in 37 (19·8%) of 187 patients in middle-HDI countries, and in 46 (35·9%) of 128 patients in low-HDI countries (p < 0·001). Interpretation: Countries with a low HDI carry a disproportionately greater burden of SSI than countries with a middle or high HDI and might have higher rates of antibiotic resistance. In view of WHO recommendations on SSI prevention that highlight the absence of high-quality interventional research, urgent, pragmatic, randomised trials based in LMICs are needed to assess measures aiming to reduce this preventable complication

Mortality from gastrointestinal congenital anomalies at 264 hospitals in 74 low-income, middle-income, and high-income countries: a multicentre, international, prospective cohort study

Summary Background Congenital anomalies are the fifth leading cause of mortality in children younger than 5 years globally. Many gastrointestinal congenital anomalies are fatal without timely access to neonatal surgical care, but few studies have been done on these conditions in low-income and middle-income countries (LMICs). We compared outcomes of the seven most common gastrointestinal congenital anomalies in low-income, middle-income, and high-income countries globally, and identified factors associated with mortality. Methods We did a multicentre, international prospective cohort study of patients younger than 16 years, presenting to hospital for the first time with oesophageal atresia, congenital diaphragmatic hernia, intestinal atresia, gastroschisis, exomphalos, anorectal malformation, and Hirschsprung’s disease. Recruitment was of consecutive patients for a minimum of 1 month between October, 2018, and April, 2019. We collected data on patient demographics, clinical status, interventions, and outcomes using the REDCap platform. Patients were followed up for 30 days after primary intervention, or 30 days after admission if they did not receive an intervention. The primary outcome was all-cause, in-hospital mortality for all conditions combined and each condition individually, stratified by country income status. We did a complete case analysis. Findings We included 3849 patients with 3975 study conditions (560 with oesophageal atresia, 448 with congenital diaphragmatic hernia, 681 with intestinal atresia, 453 with gastroschisis, 325 with exomphalos, 991 with anorectal malformation, and 517 with Hirschsprung’s disease) from 264 hospitals (89 in high-income countries, 166 in middleincome countries, and nine in low-income countries) in 74 countries. Of the 3849 patients, 2231 (58·0%) were male. Median gestational age at birth was 38 weeks (IQR 36–39) and median bodyweight at presentation was 2·8 kg (2·3–3·3). Mortality among all patients was 37 (39·8%) of 93 in low-income countries, 583 (20·4%) of 2860 in middle-income countries, and 50 (5·6%) of 896 in high-income countries (p<0·0001 between all country income groups). Gastroschisis had the greatest difference in mortality between country income strata (nine [90·0%] of ten in lowincome countries, 97 [31·9%] of 304 in middle-income countries, and two [1·4%] of 139 in high-income countries; p≤0·0001 between all country income groups). Factors significantly associated with higher mortality for all patients combined included country income status (low-income vs high-income countries, risk ratio 2·78 [95% CI 1·88–4·11], p<0·0001; middle-income vs high-income countries, 2·11 [1·59–2·79], p<0·0001), sepsis at presentation (1·20 [1·04–1·40], p=0·016), higher American Society of Anesthesiologists (ASA) score at primary intervention (ASA 4–5 vs ASA 1–2, 1·82 [1·40–2·35], p<0·0001; ASA 3 vs ASA 1–2, 1·58, [1·30–1·92], p<0·0001]), surgical safety checklist not used (1·39 [1·02–1·90], p=0·035), and ventilation or parenteral nutrition unavailable when needed (ventilation 1·96, [1·41–2·71], p=0·0001; parenteral nutrition 1·35, [1·05–1·74], p=0·018). Administration of parenteral nutrition (0·61, [0·47–0·79], p=0·0002) and use of a peripherally inserted central catheter (0·65 [0·50–0·86], p=0·0024) or percutaneous central line (0·69 [0·48–1·00], p=0·049) were associated with lower mortality. Interpretation Unacceptable differences in mortality exist for gastrointestinal congenital anomalies between lowincome, middle-income, and high-income countries. Improving access to quality neonatal surgical care in LMICs will be vital to achieve Sustainable Development Goal 3.2 of ending preventable deaths in neonates and children younger than 5 years by 2030

Reducing the environmental impact of surgery on a global scale: systematic review and co-prioritization with healthcare workers in 132 countries

Abstract Background Healthcare cannot achieve net-zero carbon without addressing operating theatres. The aim of this study was to prioritize feasible interventions to reduce the environmental impact of operating theatres. Methods This study adopted a four-phase Delphi consensus co-prioritization methodology. In phase 1, a systematic review of published interventions and global consultation of perioperative healthcare professionals were used to longlist interventions. In phase 2, iterative thematic analysis consolidated comparable interventions into a shortlist. In phase 3, the shortlist was co-prioritized based on patient and clinician views on acceptability, feasibility, and safety. In phase 4, ranked lists of interventions were presented by their relevance to high-income countries and low–middle-income countries. Results In phase 1, 43 interventions were identified, which had low uptake in practice according to 3042 professionals globally. In phase 2, a shortlist of 15 intervention domains was generated. In phase 3, interventions were deemed acceptable for more than 90 per cent of patients except for reducing general anaesthesia (84 per cent) and re-sterilization of ‘single-use’ consumables (86 per cent). In phase 4, the top three shortlisted interventions for high-income countries were: introducing recycling; reducing use of anaesthetic gases; and appropriate clinical waste processing. In phase 4, the top three shortlisted interventions for low–middle-income countries were: introducing reusable surgical devices; reducing use of consumables; and reducing the use of general anaesthesia. Conclusion This is a step toward environmentally sustainable operating environments with actionable interventions applicable to both high– and low–middle–income countries

Perceived speed differences explain apparent compression in slit viewing

When a figure moves behind a stationary narrow slit, observers often report seeing the figure as an integrated whole, a phenomenon known as slit viewing or anorthoscopic perception. Interestingly, in slit viewing, the figure is perceived compressed along the axis of motion, e.g., a circle is perceived as an ellipse. Underestimation of the speed of the moving object was offered as an explanation for this apparent compression. We measured perceived speed and compression in anorthoscopic perception and found results that are inconsistent with this hypothesis. We found evidence for an alternative hypothesis according to which apparent compression results from perceived speed differences between different parts of the figure, viz., the trailing parts are perceived to move faster than the leading parts. These differences in the perceived speeds of the trailing and the leading edges may be due to differences in the visibilities of the leading and trailing parts. We discuss our findings within a non-retinotopic framework of form analysis for moving objects

SOME HEAVY METAL LEVELS IN MUSCLE TISSUE OF SEVEN FISH SPECIES FROM THE SUGLA AND BEYSEHIR LAKES, TURKEY

WOS: 000379797800039Phoxinellus anatolicus, Carassius gibelio, Sander lucioperca, Vimba vimba tenella, Capoeta capoeta, Tinca tinca from Sugla Lake (Turkey) and P. anatolicus, Scardinius erythrophthalmus, T. tinca from Beysehir Lake (Turkey) are economically important fish species and these fish have been consumed as food by local people. P. anatolicus is also endangered and endemic species from Turkey. In this study, concentrations of Cd, Co, Cr, Fe, Mn, Ni, Pb and Zn were determined in muscle tissue of these fish by using atomic absorption spectrometer. Levels of metals in the muscle tissue of all the fish specimens were compared with results of previous studies, the tolerance levels of national and international guidelines and the levels of Provisional Tolerable Weekly Intake (PTWI) limits set by FAO/WHO. Concentrations of Cd, Cr, Ni and Pb in the muscle tissue of all the fish specimens from Sugla and Beysehir Lakes exceeded the tolerance levels of national and international guidelines. However, concentrations of Cd, Fe, Pb and Zn were below PTWI limits. Therefore, in terms of these metal levels, consumption of fresh fillet of examined seven fish species (weekly up to about 0.3 kg/person) doesn't seem to be objectionable for human health.Selcuk University Scientific Research Projects Coordination Unit (BAP) [15701159]This study was supported by Selcuk University Scientific Research Projects Coordination Unit (BAP Project No: 15701159)

Shape distortions and Gestalt grouping in anorthoscopic perception

When a figure moves behind a stationary narrow slit, observers often report seeing the figure as a whole, a phenomenon called slit viewing or anorthoscopic perception. Interestingly, in slit viewing, the figure is perceived compressed along the axis of motion. As with other perceptual distortions, it is unclear whether the perceptual space in the vicinity of the slit or the representation of the figure itself undergoes compression. In a psychophysical experiment, we tested these two hypotheses. We found that the percept of a stationary bar, presented within the slit, was not distorted even when at the same time a circle underwent compression by moving through the slit. This result suggests that the compression of form results from figural rather than from space compression. In support of this hypothesis, we found that when the bar was perceptually grouped with the circle, the bar appeared compressed. Our results show that, in slit viewing, the distortion occurs at a non-retinotopic level where grouped objects are jointly represented

A second harmonic based resonance characterization method for MEMS electrostatic resonators

This paper presents a novel read-out approach both for eliminating parasitic feedthrough current and for enhancing the quality-factor (Q) of the resonating system at the same time. A new resonance characterization method based on sensing second harmonic component of the resonators was developed. Utilizing this method, the feedthrough current was eliminated and the signal-to-background ratio was increased from 0.9 dB to 35.5 dB. Furthermore, the Q of the resonating system was improved by 65% experimentally. It was shown that this method is suitable for eliminating both capacitive and resistive feedthrough current without using complex MEMS designs and interface electronics. (C) 2018 Elsevier B.V. All rights reserved