CURRENT TREND IN RESEARCH ABOUT INVISALIGN® SUCCESS OUTCOME: A SYSTEMATIC REVIEW USING PRISMA GUIDELINE

ABSTRACTBackground: While some researches have claimed that Invisalign® is successful in creating meaningful tooth movement, there is still no comprehensive literature review that summarizes them using one valid and reliable parameter. American Board of Orthodontics-Model Grading System (ABO-MGS) is an objective measurement for the success of orthodontic treatment. This systematic review is determined to provide scientific pieces of evidence to prove the truth of the claim using ABO-MGS. Method: English-based health sciences journal databases were searched using "Invisalign" and "Model Grading System". The databases included in this study were Pubmed, Ebscohost, Google Scholar, ScienceDirect, and MEDLINE. Inclusion criteria were clinical cross-sectional, cohort, or case-control study using human subjects who finished Invisalign treatment. Two independent authors summarized the data from the obtained articles using predefined data fields and discussed the data result together. Result: Out of 60 studies found during the identification process, only 6 studies were included in the qualitative analysis. Only one of them studied the efficacy of Invisalign® by using ABO-MGS to measure the pre- and post-treatment model. Invisalign® mostly successful in creating change for alignment, overjet, and interproximal contact. Other categories were not that successful to be treated with Invisalign. Conclusion: Invisalign®‘s success is mostly pursued by correcting the malocclusion in the anterior region. Given the scarce amount of reliable evidence available, it is suggested that more studies are required to be able to draw a further conclusion.

Choroidal Thickness Profile in Chorioretinal Diseases: Beyond the Macula

Enhanced depth imaging optical coherence tomography (EDI-OCT) and swept-source OCT (SS-OCT) have emerged as essential diagnostic tools in the study and management of various chorioretinal diseases. Evidence from early clinical studies using EDI-OCT and SS-OCT indicates that choroidal dysfunction plays a major role in the pathogenesis of chorioretinal diseases. Measurement of choroidal thickness (CT) has already become a major research and clinical method, and CT is considered as an indicator of choroidal status in a variety of ophthalmic diseases. Recently, CT measurement has also been proposed as a non-invasive marker for the early detection and monitoring of various systemic diseases. Among the several possible CT measurement locations, subfoveal CT has rapidly become a reliable parameter for measuring CT in healthy and diseased eyes. Moreover, recent advancements in OCT technology have enabled faster and wider imaging of the posterior part of the eye, allowing the various changes in CT as measured outside the macula to be shown accordingly. In this review, we first provide an overview of the results of clinical studies that have analyzed the healthy macular choroid and that in various chorioretinal diseases, and then summarize the current understanding of the choroid outside the macula. We also examine the CT profile as an index that encompasses both within and outside of the macula. Furthermore, we describe the clinical applications of ultrawide OCT, which enables visualization of the far periphery, and discuss the prospects for the development of more reliable choroidal parameters that can better reflect the choroid's characteristics.

Quantitative Evaluation of Phase Distribution in UHMWPE as Derived from a Combined Use of NMR FID Analysis and Monte Carlo Simulation

A new and robust statistical approach is explored with the objective to derive quantitative and reliable information on the molecular dynamics within distinct domains (crystalline, intermediate and amorphous domains) of ultra-high molecular weight polyethylene (UHMWPE). The method consists of a critical evaluation of the free induction decay (FID) model, which is used to generate synthetic FID with a predefined signal-to-noise ratio by Monte Carlo simulations. The application of the method is demonstrated for three UHMWPE samples. A subsequent model fitting of their synthetic FIDs revealed a unique correlation between the error, i.e., standard deviation, of the derived parameters and the FID signal-to-noise ratio (SNRFID). Moreover, it was found that the method can be used to estimate the minimum required sampling time to obtain reliable parameter estimation of the FID model to experimental data.

Comparing the symmetry of upper eyelid following unilateral ptosis correction

Background Margin Reflex Distance 1(MRD 1) only describes the central height of upper eyelid and relies on the examiner’s experience and disregards eyelid contour abnormalities. Therefore MRD 1 may not be sufficient for an acceptable result to evaluate the outcomes of ptosis surgery. The primary purpose of this study was to assess outcomes of unilateral ptosis correction based on parameters including degree of symmetry, MRD 1, peak height of the upper lid, temporal and nasal ocular surface area, and temporal/nasal area ratio with an objective, quantitative, and repeatable method. Methods This study was designed as a retrospective non-randomized case-control study. Medical records of the patients with unilateral ptosis between October 2015 and December 2020 were reviewed. Patients with unilateral ptosis who underwent surgical correction and levator function of 5 mm or greater were included in the study. Two groups were defined; ptotic eye was case group and contralateral eye was control group. Data analysis was performed Image J and Matlab softwares. Results Thirty-four patients were included in the study. Mean age of patients was 58.8 ± 12.7 years (range 15–75 years). Mean follow-up time was 19.5 ± 7.3 months (range 8–40 months). Four patients were diagnosed with congenital ptosis and 30 patients aponeurotic ptosis. Mean preoperative degree of symmetry for overall eyelid contour was 36.6 ± 27.5% (range 1–92%). Mean postoperative degree of symmetry for overall eyelid contour was 72.4 ± 16.5% (range 55–92%). Temporal/Nasal (T/N) area ratios for contralateral normal eye was 1.19 pre-postoperative, and it was 1.11 preoperatively, 1.15 postoperatively for operated ptotic eye. Conclusions This study primarily demonstrated a quantitative, objective, and repeatable method to investigate the degree of symmetry after eyelid surgeries. Secondly, this study suggested that T/N ratio may not be a reliable parameter to evaluate the eyelid symmetry.

A proof of concept study on real-time LiMAx CYP1A2 liver function assessment of donor grafts during normothermic machine perfusion

No single reliable parameter exists to assess liver graft function of extended criteria donors during ex-vivo normothermic machine perfusion (NMP). The liver maximum capacity (LiMAx) test is a clinically validated cytochromal breath test, measuring liver function based on 13CO2 production. As an innovative concept, we aimed to integrate the LiMAx breath test with NMP to assess organ function. Eleven human livers were perfused using NMP. After one hour of stabilization, LiMAx testing was performed. Injury markers (ALT, AST, miR-122, FMN, and Suzuki-score) and lactate clearance were measured and related to LiMAx values. LiMAx values ranged between 111 and 1838 µg/kg/h, and performing consecutive LiMAx tests during longer NMP was feasible. No correlation was found between LiMAx value and miR-122 and FMN levels in the perfusate. However, a significant inverse correlation was found between LiMAx value and histological injury (Suzuki-score, R = − 0.874, P < 0.001), AST (R = − 0.812, P = 0.004) and ALT (R = − 0.687, P = 0.028). Furthermore, a significant correlation was found with lactate clearance (R = 0.683, P = 0.043). We demonstrate, as proof of principle, that liver function during NMP can be quantified using the LiMAx test, illustrating a positive correlation with traditional injury markers. This new breath-test application separates livers with adequate cytochromal liver function from inadequate ones and may support decision-making in the safe utilization of extended criteria donor grafts.

Determination of the point of zero charge of pineapple (Ananas comosus L.) peel and its application as copper adsorbent

Objective: To determine the optimum pH at which the pineapple peel can adsorb the greatest amount of copper. Design/methodology/approach: Sorbent material. The size of the pineapple peel was reduced to 0.250 mm; it was chemically modified with 0.2 M NaOH and 0.2 M CaCl2. Point of zero charge (PZC). Six solutions were prepared with 0.5 g of sorbent in an aqueous medium (with a 3-8 pH range), they were stirred at 225 rpm for 48 h. The derivative method was used to plot the initial pH versus final pH, in order to determine the PZC. Copper adsorption. CuSO4 solutions were prepared in 2, 4, 6, 8 10 mg/L concentrations; 0.1 g of pineapple biomass was added adjusting the pH to 5. The solutions had a contact time of 0 to 24 h. Results: The pineapple peel had a 5.0 point of zero charge (PZC) value, which indicates that pH values higher than the PZC are required to obtain an adsorbent with a negatively charged surface and favor the copper adsorption. A 50% copper removal was obtained in all concentrations after a 1 h contact time. Limitations on study/implications: This research had no limitations. Findings/conclusions: The point of zero charge is a reliable parameter that allows the adsorption process to take place and provides a greater certainty to the metal adsorption process. Meanwhile, pineapple peel can be used as an adsorbent material, consequently reducing its accumulation in open dumps.

Humerus trochlear angle (HTa)—a possible alternative for Baumann angle in the reduction of supracondylar humerus fractures

Background The supracondylar humerus fractures are the most common fracture in children’s elbows. Generally, close reduction and percutaneous pinning can provide satisfactory outcomes after adequate reduction. Baumann angle is commonly used to evaluate reduction quality, however, it may fail to assess reduction well when the elbow is in flexion and/or when the patient is young. We conducted this study to evaluate the potential value of the humerus trochlear angle (HTa) for the reduction evaluation and compare it with the Baumann angle. Methods We retrospectively reviewed supracondylar humerus fractures in our trauma center from 2016 to 2019. Patients were grouped as followed: in the HTa group, an arthrogram was used to evaluate the HTa angle and reduction (HTa, defined by the intersection of the axis of the humerus shaft and the tangent of the articular surface of the trochlear); In the Baumann group, the Baumann angle was used to assess the reduction. Baumann angle ratio (BA of injured side/BA of contralateral side) was calculated to evaluate the reduction quality between groups. Flynn’s grading criteria were utilized to evaluate both function and cosmetic outcomes in two groups during the follow-up. Operation time, fluoroscopy shots, complications and Flynn’s grading scores were compared between groups. Results A total of 57 patients with an average age of 4.62 years and follow-up duration of 21.49 ± 5.40 months were included in the analysis. The gender and age distributions were similar in the two groups. Fluoroscopy shots in the HTa group were significantly less than in Baumann group (16.17 ± 0.73 vs. 21.85 ± 0.78, p < 0.0001), and operation time were also less in HTa group (45.78 ± 1.96 min vs. 62.21 ± 1.58 min, p < 0.0001). Baumann ratio showed no significant difference between the two groups (1.002 ± 0.023 in the Baumann group and 1.01 ± 0.023 in HTa group, p < 0.0001). Length of hospitalization, complications, and Flynn’s grading scores were similar between groups. The HTa angle was positively correlated with Baumann angle in the HTa group (R-value is 0.71 and P = 0.0002). Conclusions There was no significant difference in reduction quality and Flynn’s scores between HTa and Baumann groups. Furthermore, HTa was associated with shorter operation time and less radiation exposure in this investigation. Therefore, HTa may be a convenient and reliable parameter that could guide the reduction of supracondylar humerus fractures, especially for young children.

PaO2/FiO2 ratio forecasts COVID-19 patients’ outcome regardless of age: a cross-sectional, monocentric study

We studied the predictive value of the PaO2/FiO2 ratio for classifying COVID-19-positive patients who will develop severe clinical outcomes. One hundred fifty patients were recruited and categorized into two distinct populations (“A” and “B”), according to the indications given by the World Health Organization. Patients belonging the population “A” presented with mild disease not requiring oxygen support, whereas population “B” presented with a severe disease needing oxygen support. The AUC curve of PaO2/FiO2 in the discovery cohort was 0.838 (95% CI 0.771–0.908). The optimal cut-off value for distinguishing population “A” from the “B” one, calculated by Youden’s index, with sensitivity of 71.79% and specificity 85.25%, LR+4.866, LR−0.339, was < 274 mmHg. The AUC in the validation cohort of 170 patients overlapped the previous one, i.e., 0.826 (95% CI 0.760–0.891). PaO2/FiO2 ratio < 274 mmHg was a good predictive index test to forecast the development of a severe respiratory failure in SARS-CoV-2-infected patients. Moreover, our work highlights that PaO2/FiO2 ratio, compared to inflammatory scores (hs-CRP, NLR, PLR and LDH) indicated to be useful in clinical managements, results to be the most reliable parameter to identify patients who require closer respiratory monitoring and more aggressive supportive therapies. Clinical trial registration: Prognostic Score in COVID-19, prot. NCT04780373 https://clinicaltrials.gov/ct2/show/NCT04780373 (retrospectively registered).