PURPOSE: To compare the effects of empirical and modified hemostatic resuscitation for liver blast injury combined with seawater immersion. METHODS: Thirty rabbits were subjected to liver blast injury combined with seawater immersion, and were then divided into 3 groups randomly (n = 10 each): group A (no treatment after immersion), group B (empirical resuscitation with 20 mL hydroxyethyl starch, 50 mg tranexamic acid, 25 IU prothrombin complex concentrate and 50 mg/kg body weight fibrinogen concentrate), and group C (modified resuscitation with additional 10 IU prothrombin complex concentrate and 20 mg/kg body weight fibrinogen concentrate based on group B). Blood samples were gathered at specified moments for assessment of thromboelastography, routine coagulation test, and biochemistry. Mean arterial pressure, heart rate, and survival rate were also documented at each time point. The Kolmogorov-Smirnov test was used to examine the normality of data distribution. Multigroup comparisons were conducted with one-way ANOVA. RESULTS: Liver blast injury combined with seawater immersion resulted in severe coagulo-fibrinolytic derangement as indicated by prolonged prothrombin time (s) (11.53 ± 0.98 vs. 7.61 ± 0.28, p＜0.001), activated partial thromboplastin time (APTT) (s) (33.48 ± 6.66 vs. 18.23 ± 0.89, p＜0.001), reaction time (R) (min) (5.85 ± 0.96 vs. 2.47 ± 0.53, p＜0.001), decreased maximum amplitude (MA) (mm) (53.20 ± 5.99 vs. 74.92 ± 5.76, p＜0.001) and fibrinogen concentration (g/L) (1.19 ± 0.29 vs. 1.89 ± 0.32, p = 0.003), and increased D-dimer concentration (mg/L) (0.38 ± 0.32 vs. 0.05 ± 0.03, p = 0.005). Both empirical and modified hemostatic resuscitation could improve the coagulo-fibrinolytic states and organ function, as indicated by shortened APTT and R values, decreased D-dimer concentration, increased fibrinogen concentration and MA values, lower concentration of blood urea nitrogen and creatine kinase-MB in group B and group C rabbits in comparison to that observed in group A. Further analysis found that the R values (min) (4.67 ± 0.84 vs. 3.66 ± 0.98, p = 0.038), APTT (s) (23.16 ± 2.75 vs. 18.94 ± 1.05, p = 0.001), MA (mm) (60.10 ± 4.74 vs. 70.21 ± 3.01, p < 0.001), and fibrinogen concentration (g/L) (1.68 ± 0.21 vs. 1.94 ± 0.16, p = 0.013) were remarkably improved in group C than in group B at 2 h and 4 h after injury. In addition, the concentration of blood urea nitrogen (mmol/L) (24.11 ± 1.96 vs. 21.00 ± 3.78, p = 0.047) and creatine kinase-MB (U/L) (85.50 ± 13.60 vs. 69.74 ± 8.56, p = 0.013) were lower in group C than in group B at 6 h after injury. The survival rates in group B and group C were significantly higher than those in group A at 4 h and 6 h after injury (p < 0.001), however, there were no statistical differences in survival rates between group B and group C at each time point. CONCLUSIONS Modified hemostatic resuscitation could improve the coagulation parameters and organ function better than empirical hemostatic resuscitation.
Animals ; Rabbits ; Resuscitation/methods* ; Liver/injuries* ; Seawater ; Blast Injuries/therapy* ; Fibrinogen/administration & dosage* ; Male ; Tranexamic Acid/administration & dosage* ; Immersion ; Hydroxyethyl Starch Derivatives/administration & dosage*

OBJECTIVES: The metabolomics technique of LC-MS/MS combined with data analysis was used to detect changes and differences in metabolic profiles in the vitreous humor of early rat carcasses found in water, and to explore the feasibility of its use for early postmortem submersion interval (PMSI) estimation and the cause of death determination. METHODS: The experimental model was established in natural lake water with 100 SD rats were randomly divided into a drowning group (n=50) and a postmortem (CO₂ suffocation) immediately submersion group (n=50). Vitreous humor was extracted from 10 rats in each group at 0, 6, 12, 18 and 24 h postmortem for metabolomics analyses, of which 8 were used as the training set to build the model, and 2 were used as test set. PCA and PLS multivariate statistical analysis were performed to explore the differences in metabolic profiles among PMSI and causes of death in the training set samples. Then random forest (RF) algorithm was used to screen several biomarkers to establish a model. RESULTS: PCA and PLS analysis showed that the metabolic profiles had time regularity, but no differences were found among different causes of death. Thirteen small molecule biomarkers with good temporal correlation were selected by RF algorithm. A simple PMSI estimation model was constructed based on this indicator set, and the data of the test samples showed the mean absolute error (MAE) of the model was 0.847 h. CONCLUSIONS The 13 metabolic markers screened in the vitreous humor of rat corpses in water had good correlations with the early PMSI. The simplified PMSI estimation model constructed by RF can be used to estimate the PMSI. Additionally, the metabolic profiles of vitreous humor cannot be used for early identification of cause of death in water carcasses.
Animals ; Biomarkers/metabolism* ; Cadaver ; Chromatography, Liquid ; Immersion ; Postmortem Changes ; Rats ; Rats, Sprague-Dawley ; Tandem Mass Spectrometry ; Vitreous Body/metabolism* ; Water/metabolism*

PURPOSE: This study evaluated color stability of Dentca 3D-printed denture teeth, in comparison to color stabilities of four conventional types of denture teeth, upon being immersed in various colorants.MATERIALS AND METHODS: Four types of conventional prefabricated denture teeth (Surpass, GC, Artic 6, Heraeus Kulzer, Premium 6, Heraeus Kulzer, Preference, Candulor), 3D-printed denture teeth (Dentca); and Z250 (Filtek Z250, 3M ESPE) were prepared for testing. The samples were immersed in erythrosine 3%, coffee, cola, and distilled water (DW) at 37℃. Color change (ΔE) was measured by spectrophotometer before immersion and at 7, 14, and 21 days after immersion. One-way analysis of variance was performed along with Tukey's honestly significant difference multiple comparisons test (P<.05).RESULTS: No great difference was observed between the color change of Dentca denture teeth and that of conventional denture teeth in most cases (P>.05). The color change of Dentca denture teeth immersed in erythrosine 3% was greater than that of Surpass (ΔE = 0.67 ± 0.25) after 1 week; Artic 6 (ΔE = 1.44 ± 0.38) and Premium 6 (ΔE = 1.69 ± 0.35) after 2 weeks; and Surpass (ΔE = 1.79 ± 0.49), Artic 6 (ΔE = 2.07 ± 0.21), Premium 6 (ΔE = 2.03 ± 0.75), and Preference (ΔE = 2.01 ± 0.75) after 3 weeks (P<.05).CONCLUSION: A color change was observed in Dentca denture teeth when immersed in some colorants; however, the maximum value of ΔE for Dentca denture teeth was within the clinically acceptable range.
Coffee ; Cola ; Dentures ; Erythrosine ; Immersion ; Printing, Three-Dimensional ; Tooth ; Water

Postmortem interval （PMI） estimation is one of the most important and difficult academic tasks in forensic sciences. Due to the influence of the corpse itself and the water environment, corpses in water have unique corruption phenomenon and laws. Based on the experience of traditional PMI studies of corpses on land, forensic practitioners across the world have proposed a variety of practical methods for estimating postmortem submersion interval （PMSI）. This paper summarizes the literatures related to PMSI in recent years, and introduces methods to infer PMSI according to the phenomenon of corpses, the development of insects, the succession pattern of aquatic organisms, and the changes of other physical and chemical indexes of corpses, in order to provide some reference for the study of PMSI of corpses in water.
Animals ; Autopsy ; Cadaver ; Forensic Medicine ; Immersion ; Postmortem Changes

PURPOSE: The aim of this study was to evaluate the influence of polishing methods on the color stability of composite resins. MATERIALS AND METHODS: Two bulk-fill and four conventional resin composites were filled in cylindrical molds (6 mm diameter, 4 mm height) and light-cured. The specimens were stored in 34℃ distilled water for 24 h. Spectrophotometer was used to determine the color value according to the CIE L(*)a(*)b(*) color space. Each group was divided into three groups according to polishing methods (n = 5). Group 1 was control group (Mylar strip group), group 2 was polished with PoGo, and group 3 was polished with Sof-Lex Spiral wheels. Color evaluation was performed weekly for 4 weeks after immersion in 34℃ distilled water. The results were analyzed by generalized least squares method (P < 0.05). RESULTS: Generalized least squares analysis revealed that Sof-Lex Spiral wheels group showed the significantly lower ΔE values compared to PoGo and control group (P < 0.05). The ΔE values of polished group showed the significantly lower than the ΔE values of unpolished group (P < 0.05). Regarding color changes of composite resins, there was no significant difference between the ΔE values of Filtek Z250 and Filtek Z350 XT Universal restorative in all time intervals (P < 0.05). Tetric N-Ceram Bulk Fill showed the significantly lower ΔE values compared to other composite resins in 1, 2, 3 weeks (P < 0.05). CONCLUSION: Within the limitations of this study, polishing methods influence the color stabilities of composite resins. The group polished with Sof-Lex Spiral Wheels showed more resistance to discoloration than group polished with PoGo.
Absorption ; Composite Resins ; Fungi ; Immersion ; Least-Squares Analysis ; Methods ; Water

PURPOSE: With the ever-changing cultural makeup of society, the ability to deliver culturally appropriate healthcare is essential. An educational method aimed at increasing cultural knowledge and sensitivity in the education of healthcare professionals is cultural immersion, which creates opportunities for transformational learning through direct interactions with culturally diverse populations. The purpose of this systematic review was to examine the qualitative effects of cultural immersion experiences on graduate-level healthcare professional students. METHODS: A search of the CINAHL (Cumulative Index to Nursing and Allied Health Literature) and ERIC (Education Resources Information Center) databases was performed, utilizing search terms including cultural immersion, cultural sensitivity, educational outcomes, and healthcare professionals. The search was limited to publications within the last 10 years. The articles were screened according to title, abstract, and full-text following the application of inclusion/exclusion criteria. Themes identified within each article were collected and categorized, using a qualitative methodology, into 5 overarching domains to assess the educational experiences. Studies were scored for quality using the qualitative portion of the McGill Mixed Methods Appraisal Tool–2011. RESULTS: Nine studies incorporating a total of 94 participants with experiences in 14 culturally diverse environments revealing 47 individually identified themes were included in the review. The results indicated that all cultural immersion experiences stimulated increased cultural awareness and sensitivity. CONCLUSION: Cultural immersion experiences produced a positive, multi-domain effect on cultural learning in students of the health professions. The results of this review provide support for implementing cultural immersion experiences into the education of healthcare professionals with the goal of increasing cultural sensitivity.
Delivery of Health Care ; Education ; Health Occupations ; Humans ; Immersion ; Learning ; Methods ; Nursing

OBJECTIVES: The purpose of this study was to investigate the effects of dry syrups on bovine tooth surfaces. METHODS: Each specimen of the extracted bovine teeth enamel was treated with two types of dry syrup (experimental group), mineral water (negative control group), and liquid syrup (positive control group) (n=12 per group). The specimens were immersed for 1, 5, and 10 minutes and subsequently analyzed for surface microhardness changes using a Vickers hardness tester. RESULTS: The surface microhardness of sound enamel decreased as the immersion time increased. In addition, the microhardness difference (ΔVHN) among the groups after immersion for 10 minutes in both liquid syrup and two types of dry syrup was higher than that after immersion in mineral water (P<0.05). There were significant differences between the liquid syrup group and the two dry syrup groups (P<0.05). However, there was no significant difference between the two groups of dry syrup (P>0.05). CONCLUSIONS: These results imply the erosive potential of dry syrup on tooth surfaces. The longer the contact time with teeth, greater is the risk of dental erosion. Therefore, it is recommended that the mouth be rinsed with water after drinking the syrup.
Dental Enamel ; Drinking ; Hardness Tests ; Immersion ; Mineral Waters ; Mouth ; Tooth ; Water

OBJECTIVES: We examined the effect of commercial plum beverages on dental erosion and whether the addition of calcium to these beverages would inhibit dental erosion. METHODS: We analyzed three groups as follows: Maesil 1 group (Chorok Maesil), Maesil 2 group (Sunkist plum), both of which were selected from commercially-available plum beverages, and Calcium-added maesil group (addition of 3% calcium to Chorok Maesil). For negative and positive control groups, Jeju Samdasoo and Coca Cola were selected, respectively. The characteristics of the experimental beverages were analyzed, and the specimens were immersed in the experimental beverage. The degree of erosion was measured by Vickers hardness number (VHN) and scanning electron microscope images. RESULTS: Positive control group had the lowest pH (2.50±0.03), followed by Maesil 2 (pH 2.59±0.01), Maesil 1 (pH 2.81±0.02), calcium-added maesil (pH 4.19±0.01), and negative control group (pH 7.57±0.06). Significant differences were found in surface microhardness between positive control, Maesil 1, Maesil 2 and calcium-added maesil group before immersion and at 30 minutes after immersion (P<0.05), and change in VHN (positive control group, −80.94±20.63; Maesil 1 group, −69.33±24.88; and Maesil 2 group, −78.49±18.60 in comparison with negative control group, −6.57±26.73). There was no significant difference (P<0.05) in change in VHN between calcium-added maesil (−13.02±17.33) and negative control group. CONCLUSIONS: Plum beverages can potentially induce dental erosion due to their low pH. However, adding calcium to these beverages can reduce the risk of dental erosion. Therefore, the risk of dental erosion must be considered during consumption of plum beverages, and the addition of calcium into plum beverages may be considered as a way to prevent dental erosion.
Beverages ; Calcium ; Coca ; Cola ; Hardness ; Hydrogen-Ion Concentration ; Immersion ; Prunus domestica

PURPOSE: The aim of this study was to compare the effect of different finishing and polishing techniques on water absorption, water solubility, and microhardness of ceramic or glass-polymer based computer-aided design and computer-aided manufacturing (CAD/CAM) materials following thermocycling. MATERIALS AND METHODS: 150 disc-shaped specimens were prepared from three different hybrid materials and divided into five subgroups according to the applied surface polishing techniques. All specimens were subjected up to #4000 grit SiC paper grinding. No additional polishing has been done to the control group (Group I). Other polishing procedures were as follows: Group II: two-stage diamond impregnated polishing discs; Group III: yellow colored rubber based silicone discs; Group IV: diamond polishing paste; and Group V: Aluminum oxide polishing discs. Subsequently, 5000-cycles of thermocycling were applied. The analyses were conducted after 24 hours, 7 days, and 30 days of water immersion. Water absorption and water solubility results were analyzed by two-way ANOVA and Tukey post-hoc tests. Besides, microhardness data were compared by Kruskal-Wallis and Mann-Whitney U tests (P<.05). RESULTS: Surface polishing procedures had significant effects on water absorption and solubility and surface microhardness of resin ceramics (P<.05). Group IV exhibited the lowest water absorption and the highest microhardness values (P<.05). Immersion periods had no effect on the microhardness of hybrid ceramic materials (P>.05). CONCLUSION: Surface finishing and polishing procedures might negatively affect physical properties of hybrid ceramic materials. Nevertheless, immersion periods do not affect the microhardness of the materials. Final polishing by using diamond polishing paste can be recommended for all CAD/CAM materials.
Absorption ; Aluminum Oxide ; Ceramics ; Computer-Aided Design ; Dental Polishing ; Diamond ; Immersion ; Rubber ; Silicon ; Silicones ; Solubility ; Water

PURPOSE: The purpose of this study is to investigate the changes of osteoclast differentiation inhibition according to the period of precipitation when titanium disks were immersed in Modified simulated body fluid (mSBF). MATERIALS AND METHODS: Titanium alloy (Ti grade III) disks with machined surfaces and anodized surfaces were immersed in distilled water and mSBF, respectively. The immersion periods were 7 days, 14 days, 21 days and 28 days, and the control group was immersed in distilled water for each period. RAW 264.7 cells capable of differentiating into osteoclasts were used to measure the number of adherent cells, the measurement of TRAP activity, and the expression pattern of NFATc1 by western blotting. RESULTS: The degree of inhibition of osteoclast differentiation was found to be statistically significant when the disks were immersed in mSBF for more than 14 days on both machined surfaces and anodized surfaces. There was no correlation between immersion time and cell attachment. When the disks were immersed for more than 14 days, TRAP activity was decreased and NFATc1 expression was inhibited. Futhermore, the decrease in TRAP activity and the inhibition of NFATc1 expression remained unchanged. CONCLUSION: Immersion of titanium disks in mSBF for more than 14 days can prevent RAW 264.7 cells from differentiating into osteoclasts. Inhibition activity does not change even if the immersion period is for more than 14 days.
Alloys ; Blotting, Western ; Body Fluids ; Immersion ; Osteoclasts ; RAW 264.7 Cells ; Titanium ; Water