Photodynamic Therapy in Oral Cancer: A Narrative Review.

Methods: A comprehensive search in PubMed, Scopus, and Google Scholar was performed using relevant keywords to structure this narrative review. Only English articles were included and assessed according to titles, abstracts, and full texts. Background: Photodynamic therapy (PDT) is applied for targeting pre-malignancy and malignancies in the head and neck, skin, lungs, and gastrointestinal tract and has been greatly promising in reducing disfigurement and morbidity. This method includes a light-sensitive medicine known as a photosensitizer and a light source used through a minimally invasive surgical tool. Objective: This study aimed to review the application of PDT in managing head and neck cancers (HNCs) and provide an overview of the most recent advances in PDT and its efficiency in increasing the long-term life quality of patients with HNC. Results: The light source irradiates light at an appropriate wavelength that can be absorbed by the sensitizer and produce cytotoxic free radicals that can kill tumor cells, impair microvasculature in the tumor microenvironment, and stimulate further inflammatory responses of the immune system. Patients with either early lesions or advanced disease conveniently accept to receive PDT in outpatient clinics. Therefore, this simple technique is considered a novel and promising approach that can be used either individually or in association with other methods. However, its application as a management method in oral malignancies has yet to be studied. PDT is also suggested as a promising adjuvant treatment with better functional results. Then, it is possible to conclude that PDT's effectiveness in treating various tumors has been shown to depend on the depth of the lesion location. Its safety is acceptable, but its limited irradiation depth confines its application in the advanced stages of cancer. Conclusions: PDT is critically applicable in the early diagnosed cancers and superficial tumors where many heads and neck lesions settle as an ideal candidate for PDT because of the possibility of accurate evaluation of lesions and providing appropriate irradiation at these sites.

Clinical evaluation of marginal fit of uncemented CAD-CAM monolithic zirconia three-unit restorations in anterior areas, using scannable and conventional polyvinyl siloxane impression materials.

BACKGROUND: The accuracy of impression techniques determines the marginal fit of fixed prostheses. Marginal accuracy plays a main role in the success and failure of treatments. This in-vivo study evaluated the marginal fit of anterior three-unit monolithic zirconia fixed partial dentures (FPDs) using conventional and scannable polyvinyl siloxane impression materials. METHODS: Ten patients were selected to replace the lateral teeth with a three-unit monolithic zirconia bridge. For each patient, in the first group, an impression was made with a two-step putty-wash technique using scannable polyvinyl siloxane material (BONASCAN; DMP, Greece). In the identical session, as the second group, an impression of conventional putty-wash polyvinyl siloxane was taken (BONASIL A+ Putty; DMP, Greece). The marginal discrepancy was measured through the replicas, which were cut perpendicularly within the buccolingual and mesiodistal directions. An Independent t-test was employed for data analyses (P < 0.05). RESULTS: The marginal discrepancy in a conventional method for central abutment in mid-buccal, mid-lingual, mid-mesial, and mid-distal was higher than in the scannable method but it was not significant (P > 0.05). Also, the marginal discrepancy for canine abutment in the conventional method was higher than in the scannable method, but it was not significant, either (P > 0.05). CONCLUSIONS: FPDs fabricated from both scannable and conventional impression materials were not superior to each other in marginal fit for both central and canine abutments by evaluation using the replica technique.

Evaluating the effect of heat stress on cognitive performance of petrochemical workers: A field study.

INTRODUCTION: Heat stress disrupts blood hormones and reduces workers' cognitive performance. To further shed light on the dysfunction of heat stress, the present study aimed to evaluate its effect on cognitive performance of petrochemical workers. MATERIALS AND METHODS: This descriptive-analytical cross-sectional study was conducted in 2020 in one of the Iranian petrochemical companies. Participants were divided into 2 case groups and 1 control group. They worked 12 h and their shift entialed one week working day and one week working night. According to the ISO 7243 standard, the heat stress index of employees was measured at the beginning, in the middle and at the end of the shift separately. Continuous Performance Test (CPT) and N-back cognitive performance tests were performed at the beginning, in the middle and at the end of the shift to determine the level of cognitive performance. The data were analyzed using SPSS software version 20 and the significance level was set at 0.05. RESULTS: Comparison of the results in the continuous performance test showed significant differences between the three groups with regard to the omission error and response time at the end of the shift. Moreover, according to the working memory test, participants reaction time during the shift significantly increased. Besides, average correct responses significantly reduced during the shift. Finally, the heat stress throughout the shift had a significant effect on the commission error and the response time of individuals. CONCLUSION: Heat stress affects people's cognitive performance in such a way that it can decrease their cognitive performance by increasing the commission error and response time and reducing the average correct response of site operators, generally reducing the cognitive performance of people at the end of the shift.

Path planning in three dimensional live environment with randomly moving obstacles for viscoelastic bio-particle.

Significant capabilities of atomic force microscopy (AFM) such as operating in various environments and scales made it a useful device in different operations. According to AFM abilities and applications, in this work, the path through the live environment with fixed and moving obstacles that are distributed all over the space randomly has been provided. The optimized path has been discovered in this article based on the applications mentioned above. Since for biological applications, the tool's accuracy plays an important role in success and reliability of the operation, in this article, the cost function is defined as combination of the tool's error, the maximum applied force on the tool, and the maximum deformation of the particle to be minimized. In this regard, constraints which limit the particle's motion and speed such as critical force and time and the maximum applied force have been considered. While in living environment obstacle existence is possible, fixed and moving obstacles with random profile and distribution will be considered. Routing of viscoelastic particle considering above conditions has been performed and comparison with the previous works proved the correctness of the path. The effects of different constraints have been compared using path optimization in different situations. The time of path planning for critical force and time was about 117.657, for the maximum applied force 118.240, and for all constraints together was 120.540 s which shows that the applied force constraint has been more effective than others and increases path planning time.

A Comparison of Beclomethasone Aqueous Spray and Aerosol Delivery System in Nasal Polyps: A Randomized Control Trial.

BACKGROUND: Considering the effect of beclomethasone on allergic rhinitis or nasal polyps, it has been attempted to find the best method of using this drug to have the maximum effect and increase the patients' satisfaction. Therefore, the aim of this study was to compare the efficacy of beclomethasone aerosol and aqueous nasal sprays in the patients with nasal polyps. MATERIALS AND METHODS: This double-blind randomized clinical trial was conducted on 60 patients with nasal polyps. The patients were divided into two groups. The first group (beclomethasone dipropionate aqueous [BD-AQ] group) was treated with daily two puffs of beclomethasone aqueous nasal spray 50 µg in each nostril, and the second group (beclomethasone dipropionate aerosol [BD-A] group) was treated with two puffs of aerosol beclomethasone 50 µg in each nostril daily for 6 months. At the beginning of the study, the sino-nasal outcome test-22 (SNOT-22) and Lund-Mackay scores were recorded after the evaluation of disease status and the severity of symptoms. RESULTS: The results of this study demonstrated that the mean changes in Lund-Mackay and SNOT-22 scores (83 ± 6.30 and 4.25 ± 31.60, respectively) in the BD-A group were significantly higher than the BD-AQ group (2.01 ± 3.87and 9.83 ± 24.13, respectively) (P < 0.05), but there was no significant difference in the patients' satisfaction between the two groups (P > 0.05). CONCLUSION: According to the results of this study, patients with nasal polyps showed a significant improvement following both the interventions, but the disease severity in the BD-A group was significantly higher than the BD-AQ group based on the mean values of Lund-Mackay score.

Using a Deep Learning Algorithm and Integrated Gradients Explanation to Assist Grading for Diabetic Retinopathy.

PURPOSE: To understand the impact of deep learning diabetic retinopathy (DR) algorithms on physician readers in computer-assisted settings. DESIGN: Evaluation of diagnostic technology. PARTICIPANTS: One thousand seven hundred ninety-six retinal fundus images from 1612 diabetic patients. METHODS: Ten ophthalmologists (5 general ophthalmologists, 4 retina specialists, 1 retina fellow) read images for DR severity based on the International Clinical Diabetic Retinopathy disease severity scale in each of 3 conditions: unassisted, grades only, or grades plus heatmap. Grades-only assistance comprised a histogram of DR predictions (grades) from a trained deep-learning model. For grades plus heatmap, we additionally showed explanatory heatmaps. MAIN OUTCOME MEASURES: For each experiment arm, we computed sensitivity and specificity of each reader and the algorithm for different levels of DR severity against an adjudicated reference standard. We also measured accuracy (exact 5-class level agreement and Cohen's quadratically weighted κ), reader-reported confidence (5-point Likert scale), and grading time. RESULTS: Readers graded more accurately with model assistance than without for the grades-only condition (P < 0.001). Grades plus heatmaps improved accuracy for patients with DR (P < 0.001), but reduced accuracy for patients without DR (P = 0.006). Both forms of assistance increased readers' sensitivity moderate-or-worse DR: unassisted: mean, 79.4% [95% confidence interval (CI), 72.3%-86.5%]; grades only: mean, 87.5% [95% CI, 85.1%-89.9%]; grades plus heatmap: mean, 88.7% [95% CI, 84.9%-92.5%] without a corresponding drop in specificity (unassisted: mean, 96.6% [95% CI, 95.9%-97.4%]; grades only: mean, 96.1% [95% CI, 95.5%-96.7%]; grades plus heatmap: mean, 95.5% [95% CI, 94.8%-96.1%]). Algorithmic assistance increased the accuracy of retina specialists above that of the unassisted reader or model alone; and increased grading confidence and grading time across all readers. For most cases, grades plus heatmap was only as effective as grades only. Over the course of the experiment, grading time decreased across all conditions, although most sharply for grades plus heatmap. CONCLUSIONS: Deep learning algorithms can improve the accuracy of, and confidence in, DR diagnosis in an assisted read setting. They also may increase grading time, although these effects may be ameliorated with experience.