Accuracy and reliability of lower dental arch reconstructions

Introduction: In the literature, there is information regarding the accuracy of models generated by conventional impression materials and intraoral scanners, but data on the accuracy of 3D models generated from cone-beam computed tomography (CBCT) is still lacking.Aim: The aim of this article is to investigate and compare the accuracy of tooth reconstructions made on 3D models generated from CBCT and intraoral scanning, as well as on plaster models from conventional impression materials, to the results of intraoral measurements using a digital caliper.Materials and Methods: The study included a total of 38 individuals (16 males and 22 females). After the initial examination, we scheduled appointments for the approved participants to undergo clinical procedures and imaging studies in the following sequence: 1. placement of composite markers; 2. physical measurements; 3. intraoral scanning; 4. CBCT; 5. capturing a conventional impression; 6. removal of composite markers. Following are the laboratory and measurement stages for the study: 7. casting gypsum models; 8. measurements on gypsum models; 9. converting the DICOM files from CBCT scans to STL files; 10. conducting measurements on digital models from CBCT and intraoral scanning.Results: Results from the reliability assessment of the researcher’s measurements for the studied modalities indicate a correlation coefficient ranging from moderate to excellent with very high statistical significance. Concerning accuracy, differences are observed between individual modalities. Conclusion: In summary, conventional methods and materials still outperform intraoral scanners in terms of the accuracy of the obtained reconstructions. 3D models generated from CBCT scans are generally the least satisfactory among the tested modalities, with deviations typically within clinically acceptable values

Large solitary luteinized follicle cyst of pregnancy and puerperium: report of two cases

We describe two cases of large solitary luteinized follicle cyst of pregnancy and puerperium (LSLFCPP) with new clinicopathologic findings. The first case occurred in a 40-year old woman who was found to have a left ovarian mass during the third trimester of pregnancy. The patient delivered a full term healthy female infant via caesarean section. The ovarian mass was removed by oophorectomy. The specimen showed a unilocular, thin-walled, clear fluid filled cyst measuring 15 × 12 × 5 cm. Microscopically, the cyst was lined by single to multiple layers of luteinized cells with mainly small, round and regular nuclei and focally enlarged, bizarre, and hyperchromatic nuclei. Occasional mitotic figures were seen. The cyst wall showed marked edema and nests of luteinized cells that were morphologically similar to the cyst lining cells. Groups of lesional cells were surrounded by reticulin fibers. The patient has been healthy without disease after 7 years. The second patient was a 29-year old pregnant woman who was found to have a right ovarian cyst by ultrasound at 14-week gestation. She then presented with preterm labor at 33-week gestation and delivered a healthy female infant via caesarean section. A right salpingo-oophorectomy was performed. Gross inspection of the specimen revealed a unilocular, brown mucoid fluid filled cyst measuring 14 × 11 × 9 cm. The cyst surfaces were smooth, and the cyst wall exhibited marked edema. Microscopic examination showed features similar to the first case: cyst lined by luteinized cells with focal large nuclei, scattered nests of luteinized cells in the edematous fibrous wall, and reticulin fibers surrounding large nests of lesional cells. No mitoses, however, were identified in the second case. The patient has been well without disease 1 year after surgery. These two cases contribute to a better understanding of LSLFCPP. Our case in the 40-year old patient is the first to show mitotic figures in LSLFCPP and suggests that the presence of occasional mitoses should not exclude a diagnosis of LSLFCPP. The lesion in the second patient caused preterm labor. Nevertheless, absence of disease recurrence in our patients demonstrates a benign nature of LSLFCPP

Partial Hydatidiform Mole Complicated by Multinodular Goiter. A Case from Bulgaria

Partial mole occurs when an egg is fertilized by two spermatozoids or by one spermatozoid which reduplicates itself yielding most commonly triploid genotype of 69,XXY. We present a case of a partial hydatidiform mole associated with multinodular goiter. The patient is a 27-year-old primigravida who presented for termination of non-viable pregnancy at 11 weeks gestation. Her ultrasound examination showed lack of growth and presence of degenerative changes. Thyroid gland ultrasound scan revealed multinodular goiter. Flow cytometry analysis showed triploid pick index of 1.46 which confirmed the triploid karyotype (69, ???) detected by genetic studies. Partial hydatidiform mole could be a risk factor for the occurrence of nodular goiter and even hyperthyroidism as the underlying hormonal imbalance triggers pathogenetic mechanisms of the thyroid dysfunction

Интелигентен туристически екскурзовод – генериране на амбиент-ориентирани маршрути и дигитално класифициране на елементи от културното и историческо наследство на България

Едни от сферите на приложение на дигиталните мобилни асистенти са интелигентният транспорт и туристическите екскурзоводи. Такива персонализирани системи имат за цел да улеснят все по-трудния избор за най-подходяща транспортна опция, с оглед на личните предпочитания и навици, текуща локация и наличните опции в реално време. За реализиране на интелигентен туристически екскурзовод е необходимо разработване на персонализирани модели, които включват не само статична информация за маршрути и дестинации, но и да се взeмат предвид личните предпочитания на потребителя, както и динамично да се реагира на непланирани промени и обстоятелства в реалния свят. В сферата на интелигентните системи такива променливи физически характеристики във времето и пространството (така наречените амбиентни характеристики) имат все по-съществена роля и все по-голяма тежест в степента на полезност за крайния потребител. Този туристически екскурзовод е неизменен спътник, който помага на потребителя да се потопи в богатата история и културното наследство на България. Съвременните технологии в областта на изкуствения интелект дават възможност на туриста задълбочено да се запознае с традициите и народните обичаи, получавайки детайлна информация за обкръжаващите го обекти като народни носии, архитектурни паметници и други.One of the areas of application of digital mobile assistants is intelligent transport and tourist guides. Such personalised systems aim to facilitate the increasingly difficult choice of the most appropriate transport option regarding personal preferences and habits, current location and available options in real time. To implement a smart travel guide, it is necessary to develop personalised models that include not only static information about routes and destinations, but also to take into account the personal preferences of the user and dynamically respond to unplanned real world circumstances. In the field of intelligent systems, such variable physical characteristics in time and space (so-called ambient characteristics) have a significant role in the degree of usefulness for the end user. The personal assistant is an integral part of the user experience that helps tourists immerse themselves in the rich history and cultural heritage of Bulgaria. Modern technologies in the field of artificial intelligence allow the tourist to get acquainted with the traditions and folk customs, receiving detailed information about the surrounding objects such as folk costumes, architectural monuments and others.Авторите изказват благодарност към научен проект ФП21-ФМИ-002 „Интелигентни иновационни ИКТ в научните изследвания в областта на математиката, информатиката и педагогиката на обучението“ към Фонд Научни изследвания на ПУ „Паисий Хилендарски“, за частичното финансиране на настоящата работа

Stress echocardiography for left ventricular diastolic dysfunction detection in patients with non-severe chronic obstructive pulmonary disease: a cross-sectional study

Aim To assess whether the simultaneous performance of exercise stress echocardiography and cardio-pulmonary testing (ESE-CPET) may facilitate the timely diagnosis of subclinical left ventricular diastolic dysfunction (LVDD) in patients with non-severe chronic obstructive pulmonary disease (COPD), preserved left ventricular systolic function, and exertional dyspnea or exercise intolerance. Methods This cross-sectional study, conducted between May 2017 and April 2018, involved 104 non-severe COPD patients with exertional dyspnea and preserved ejection fraction who underwent echocardiography before CPET and 1-2 minutes after peak exercise. Based on the peak E/e’ ratio, patients were divided into the group with stressinduced LVDD – E/e’>15 and the group without stress-induced LVDD. We assessed the association between LVDD and the following CPET variables: minute ventilation, peak oxygen uptake (VO2), ventilatory efficiency, heart rate reserve, and blood pressure.Results During ESE-CPET, stress-induced LVDD occurred in 67/104 patients (64%). These patients had lower work load, peak VO2, O2 pulse, and minute ventilation (VE), and higher VE/VCO2 slope than patients without stress-induced LVDD (35.18 ± 10.4 vs 37.01 ± 11.11, P < 0.05). None of the CPET variables correlated with E/e’. Conclusion Combined ESE-CPET may distinguish masked LVDD in patients with non-severe COPD with exertional dyspnea and preserved left ventricular systolic function. None of the CPET variables was a predictor for subclinical LVDD

Impact of aquatic sports on the evolution of obstructive sleep apnea and snoring and other breathing disorders

Obstructive sleep apnea (OSA) is a clinical syndrome characterized by periodic reduction (hypopnea) or cessation (apnea) of airflow through the nose/mouth during sleep due to collapse of the upper respiratory tract lasting 10 seconds or more. Severe snoring, hypoxemia and micro-awakenings occur, leading to sleep fragmentation, daytime fatigue and drowsiness. One of the key factors for the development of OSA is obesity. Excessive alcohol consumption, smoking, and presence of relatives with sleep apnea are risk-increasing factors. The gold standard in diagnosis is polysomnographic examination.Various values and indices are monitored, the most important of which is the apnea/hypopnea index. Treatment includes control of risk factors and removal of breathing obstacles. In patients with more severe obstructive sleep apnea syndrome, the gold standard of treatment remains constant positive pressure ventilation during sleep.   Water sports have been part of programs for prevention of breathing disorders during sleep for many years.       Our goal is to confirm whether after active sea treatment, water sports and weight loss of patients symptoms of obstructive sleep apnea and snoring would be favorably affected, as well as to actively promote and educate our patients about a more active sports (and aquatic) life.      Results from our studies on patients with problems with the upper respiratory tract and OSA show that more than half did not practice sport. Some have common diseases, incl. allergic conditions. The influence of bad habits and the hereditary factor were confirmed as well.     Obstructive sleep apnea and snoring syndrome is a serious disease with consequences for patients and other people. Screening of at-risk patients should be continued and studies should be conducted on the effectiveness of current and new methods for diagnosing and treating the syndrome

Quality, Microstructure, and Technological Properties of Sheep

The objective of this study was to explore the effect of 24 and 48 h alkaline (2% pentasodium tripolyphosphate), acid (2% sodium lactate), and water-oil marinating (water : sun flavor oil = 1 : 1 and 2% salt) as well as brine soaking (2% salt) on microstructure, changes in protein, and lipid fractions and technological properties of sheep (m. Longissimus dorsi). Strong myofibrillar fragmentation after 48 h alkaline marinating was observed. Significant swelling and increasing of spaces between myofibrils were found after 24 h brine soaking. Marinating in water-oil emulsions did not show a significant impact on the muscle microstructure. Alkaline and acid marinating as well as salt soaking promote the myofibrillar protein solubility and increased the free amino nitrogen content. After 24 h acid and 48 h alkaline marinating SDS-PAGE electrophoresis showed increasing of 25–30 kDa protein bands. The results obtained for the lipid and protein oxidation confirm prooxidant action of the sodium lactate (2%) and antioxidant effect of polyphosphates (2%) in marinated sheep

DECODING MICROBIOME DYSBIOSIS THROUGH METAGENOMIC ALPHA DIVERSITY

Background: Sarcoidosis is a chronic inflammatory disease that can affect multiple organs. The aetiology of sarcoidosis is not fully understood, but there is increasing evidence that the microbiome may play a role. The blood microbiome is a collection of microorganisms that live in the bloodstream. It is a complex and dynamic community that is influenced by a variety of factors, including the host’s lifestyle and pathology. Recent studies have shown that people with sarcoidosis have alterations in their blood microbiome. These alterations include changes in the diversity, richness, and evenness of the microbial community. The abundance measures by which the blood microbiome diversity may detect instances of dysbiosis related to sarcoidosis aetiology. It should be clearly distinguished from microbiome changes related to unspecific inflammation or sepsis. However, the available evidence suggests that the microbiome may be a promising target for therapeutic interventions. Aim: The primary goal of this review was to assess and compare the existing metrics of microbiome composition and diversity as established by metagenomic analyses. Additionally, we aim to elucidate the potential causal relationship between these measures, the phenomenon of blood microbiome dysbiosis and the pathogenesis of sarcoidosis. Conclusion: In the present review, we investigated alpha diversity measures as characteristics of microbiome communities, examining their potential as indicators of dysbiosis, and the probablemechanisms of microbiome participation. A descriptive qualitative comparison was conducted between lung microbiome data of sarcoidosis patients and blood microbiome data of healthy adults. This comparison elucidates common taxa between the two microbiomes and identifies taxa potentially involved in sarcoidosis

Transthyretin Is Dysregulated in Preeclampsia, and Its Native Form Prevents the Onset of Disease in a Preclinical Mouse Model

Preeclampsia is a major pregnancy complication with potential short- and long-term consequences for both mother and fetus. Understanding its pathogenesis and causative biomarkers is likely to yield insights for prediction and treatment. Herein, we provide evidence that transthyretin, a transporter of thyroxine and retinol, is aggregated in preeclampsia and is present at reduced levels in sera of preeclamptic women, as detected by proteomic screen. We demonstrate that transthyretin aggregates form deposits in preeclampsia placental tissue and cause apoptosis. By using in vitro approaches and a humanized mouse model, we provide evidence for a causal link between dysregulated transthyretin and preeclampsia. Native transthyretin inhibits all preeclampsia-like features in the humanized mouse model, including new-onset proteinuria, increased blood pressure, glomerular endotheliosis, and production of anti-angiogenic factors. Our findings suggest that a focus on transthyretin structure and function is a novel strategy to understand and combat preeclampsia

Sex difference and intra-operative tidal volume: Insights from the LAS VEGAS study

BACKGROUND: One key element of lung-protective ventilation is the use of a low tidal volume (VT). A sex difference in use of low tidal volume ventilation (LTVV) has been described in critically ill ICU patients.OBJECTIVES: The aim of this study was to determine whether a sex difference in use of LTVV also exists in operating room patients, and if present what factors drive this difference.DESIGN, PATIENTS AND SETTING: This is a posthoc analysis of LAS VEGAS, a 1-week worldwide observational study in adults requiring intra-operative ventilation during general anaesthesia for surgery in 146 hospitals in 29 countries.MAIN OUTCOME MEASURES: Women and men were compared with respect to use of LTVV, defined as VT of 8 ml kg-1 or less predicted bodyweight (PBW). A VT was deemed 'default' if the set VT was a round number. A mediation analysis assessed which factors may explain the sex difference in use of LTVV during intra-operative ventilation.RESULTS: This analysis includes 9864 patients, of whom 5425 (55%) were women. A default VT was often set, both in women and men; mode VT was 500 ml. Median [IQR] VT was higher in women than in men (8.6 [7.7 to 9.6] vs. 7.6 [6.8 to 8.4] ml kg-1 PBW, P &lt; 0.001). Compared with men, women were twice as likely not to receive LTVV [68.8 vs. 36.0%; relative risk ratio 2.1 (95% CI 1.9 to 2.1), P &lt; 0.001]. In the mediation analysis, patients' height and actual body weight (ABW) explained 81 and 18% of the sex difference in use of LTVV, respectively; it was not explained by the use of a default VT.CONCLUSION: In this worldwide cohort of patients receiving intra-operative ventilation during general anaesthesia for surgery, women received a higher VT than men during intra-operative ventilation. The risk for a female not to receive LTVV during surgery was double that of males. Height and ABW were the two mediators of the sex difference in use of LTVV.TRIAL REGISTRATION: The study was registered at Clinicaltrials.gov, NCT01601223