Influence of bite force and implant elastic modulus on mandibular reconstruction with particulate-cancellous bone marrow grafts healing: An in silico investigation.

This study aims to investigate tissue differentiation during mandibular reconstruction with particulate cancellous bone marrow (PCBM) graft healing using biphasic mechanoregulation theory under four bite force magnitudes and four implant elastic moduli to examine its implications on healing rate, implant stress distribution, new bone elastic modulus, mandible equivalent stiffness, and load-sharing progression. The finite element model of a half Canis lupus mandible, symmetrical about the midsagittal plane, with two marginal defects filled by PCBM graft and stabilized by porous implants, was simulated for 12 weeks. Eight different scenarios, which consist of four bite force magnitudes and four implant elastic moduli, were tested. It was found that the tissue differentiation pattern corroborates the experimental findings, where the new bone propagates from the superior side and the buccal and lingual sides in contact with the native bone, starting from the outer regions and progressing inward. Faster healing and quicker development of bone graft elastic modulus and mandible equivalent stiffness were observed in the variants with lower bite force magnitude and or larger implant elastic modulus. A load-sharing condition was found as the healing progressed, with M3 (Ti6Al4V) being better than M4 (stainless steel), indicating the higher stress shielding potentials of M4 in the long term. This study has implications for a better understanding of mandibular reconstruction mechanobiology and demonstrated a novel in silico framework that can be used for post-operative planning, failure prevention, and implant design in a better way.

Stress Distribution of Endodontically Treated Tooth MOD Cavity Restored with Ribbon Fiber-Reinforced Composite (Wallpapering Technique) Using Finite Element Method.

Purpose: This research aimed to describe the stress distribution of an endodontically treated tooth with a mesio-occluso-distal (MOD) cavity restored with direct composite reinforced with polyethylene and e-glass ribbon fiber. Methods: This research was a descriptive study using the finite element method. A 3D model of the mandibular first molar solid after endodontic treatment with class II MOD preparation was prepared using Solidworks software. Finite element simulation was carried out using Abaqus software. In the first simulation, 180 N force was applied (vertically 90° perpendicular to the occlusal surface) at four points of loading: the tip of the mesiobuccal and distobuccal cusp, central fossa, and distal marginal ridge. For the second simulation, a 100 N force was applied at a 45° lateral angle to the occlusal surface at two loading points: the lingual slope of the mesiobuccal and distobuccal cusp. Results: This study showed that the stress concentration was located in the occlusal pit and fissure, CEJ distal area, bifurcation in dentin, and the 1/3 cervical area of root dentin. The stress value generated after vertical and lateral force did not exceed the tooth and restoration's compressive and tensile strength value. The failure occurred at the interface of enamel and composite near the loading point area due to vertical load, both on polyethylene and e-glass fiber ribbon-reinforced composite restoration. Stress distribution of an endodontically treated tooth with a MOD cavity restored with ribbon fiber-reinforced composite using the finite element method showed that the highest stress concentration occurred on the surface close to the loading point, in narrow, concave, and sharp areas, and more apically for endodontically treated teeth. Conclusion: Neither the tooth nor restoration failed after vertical and horizontal loads. The interface between enamel and composite on the occlusal surface failed.

The strength, position, and width changes of the intertropical convergence zone since the Last Glacial Maximum.

The intertropical convergence zone (ITCZ) plays a key role in regulating tropical hydroclimate and global water cycle through changes in its convection strength, latitudinal position, and width. The long-term variability of the ITCZ, along with the corresponding driving mechanisms, however, remains obscure, mainly because it is difficult to separate different ITCZ variables in paleoclimate proxy records. Here, we report a speleothem oxygen isotope (δ18O) record from southwestern Sulawesi, Indonesia, and compile it with other speleothem records from the Maritime Continent. Using the spatial gradient of speleothem δ18O along a transect across the ITCZ, we constrain ITCZ variabilities over the Maritime Continent during the past 30,000 y. We find that ITCZ convection strength overall intensified from the last glacial period to the Holocene, following changes in climate boundary conditions. The mean position of the regional ITCZ has moved latitudinally no more than 3° in the past 30,000 y, consistent with the deduction from the atmospheric energy framework. However, different from modern observations and model simulations for future warming, the ITCZ appeared narrower during both the late Holocene and most part of the last glacial period, and its expansion occurred during Heinrich stadials and the early-to-mid Holocene. We also find that during the last glacial and deglacial period, prominent millennial-scale ITCZ changes were closely tied to the variability of the Atlantic meridional overturning circulation (AMOC), whereas during the Holocene, they were predominantly modulated by the long-term variability of the Walker circulation.

Finite element stress analysis of dental cement application on endocrown and onlay restoration.

The aim of the study was to evaluate the influence of resin cement material types on tooth with endocrown and onlay restorations. The first molar was scanned using Micro-CT and underwent a modelling process to obtain the 3D model for computational simulation. Eight models were simulated in the current study with two loading conditions (720N vertical load and 200N oblique load), two types of restoration (onlay and endocrown restorations), and two resin cement variants (dual-cure resin cement and light-cure resin cement). The tooth with onlay restoration showed a significant stress reduction (up to 70%) when using light-cure resin cement compared to dual-cure resin cement. In contrast, types of cement did not affect stress distribution in the tooth with endocrown restoration. The current study found that dual-cure resin cement was preferable in Endocrown and Onlay restorations, due to dual-cure resin cement provided better bond strength compared to light-cure resin cement.

Long wavelength mid-infrared multi-gases spectroscopy using tunable single-mode slot waveguide quantum cascade laser.

Single-mode tunable quantum cascade lasers (QCLs) are promising for high-resolution and highly sensitive trace gases sensing across the mid-infrared (MIR) region. We report on the development of a tunable single-mode slot waveguide QCL array in the long wavelength part of the MIR regime (>12 µm). This laser array exhibits a tuning range of around 12 cm-1, from 735.3 to 747.3 cm-1. Using this developed single-mode tunable QCL, we demonstrate individual gas sensing, yielding the detection limit of 940 ppb and 470 ppb for acetylene and o-xylene, respectively. To verify the potential of the developed QCL array in multi-species gas detection, laser absorption measurements of two mixed gases of acetylene and o-xylene were conducted, showing the absorption features of the corresponding gases agree well with the theoretical predictions.

Effect of Giving Traditional Drinks Kameko and Pongasih from Southeast Sulawesi on Sperm Quality of Mice (Mus musculus).

<b>Background and Objective:</b> The traditional beverage of Southeast Sulawesi is Kameko and Pongasih, which is a traditional alcoholic beverage. One of the bad effects of alcohol on reproductive health is the occurrence of infertility. This research aimed to determine the effect of consuming traditional beverages of Kameko and Pongasih on the quality of sperm of mice (<i>Mus musculus</i>). <b>Materials and Methods:</b> This research used a true experiment. The samples were some healthy mice (<i>Mus musculus</i>) aged 6-8 weeks as much 24 tails and divided into 4 groups. On the 36th day after the treatment was completed, the mice were terminated and prepared for microscopic sperm quality analysis. The quality of sperm includes motility, viability, concentration and morphology. The data test uses the Shapiro-Wilk Test, One-way ANOVA and <i>post hoc</i> LSD Test. <b>Results:</b> Kameko traditional beverage had a significant influence on sperm quality with motility, morphology, sperm concentration (p = 0.000) and viability (p = 0.001). Pongasih traditional beverage has a significant influence on sperm quality with motility parameter, morphology, sperm concentration (p = 0.000) and viability (p = 0.001). Kameko and Pongasih traditional beverages did not have a significant difference in sperm quality with motility parameter (p = 0.463), viability (p = 1.000), morphology (p = 0.553) and amount of concentration (p = 0.714). <b>Conclusion:</b> South East Sulawesi traditional beverages Kameko and Pongasih have effects on mice's (<i>Mus musculus</i>) sperm quality, but there was no difference in the group of mice which have been given Kameko and Pongasih.

Beam combining of a broadly and continuously tunable quantum cascade laser.

We report a cost-efficient method to demonstrate the beam combining of five laser elements in an array of tunable slot waveguide quantum cascade lasers in the mid-infrared region at around 10 µm. An aspherical lens with five fine-tuned mini mirrors was employed to collimate the individual beams from the laser array. To verify the feasibility of this beam combining approach, the combined beams were coupled into a hollow-core fiber gas cell with a low numerical aperture (N.A.) of 0.03 and a coupling efficiency >= 0.82, for gas sensing of binary compound gases of ammonia and ethylene simultaneously.

A Giant Ovarian Cystadenoma in A 20-Year-Old Nulliparous Woman: A Case Report.

Giant ovarian cyst itself is defined as a cyst >10 cm in diameter from radiological- examination or the size of the cyst exceeds the umbilicus. Extra-large benign and malignant cysts of the ovary are uncommon and involve diagnostic and management challenges. We present the case of a 20-year-old nulliparous woman who was referred to our center with complaints of abdominal pain and heavy breathing. She benefited from a salphingo-oophorectomy laparotomy procedure. Benign and malignant gynecologic and non-gynecologic etiologies are included in the differential diagnosis of an abdominal mass. Because of the infrequent occurrence or absence of distinctive clinical presentation of the giant ovarian cyst, accurate preoperative diagnosis is challenging.

A narrative review into the impact of COVID-19 pandemic on senior high school adolescent mental health.

PROBLEM: High school teenagers are facing significant challenges during the COVID-19 pandemic. Teenagers are at risk of experiencing physical, mental, and social health problems due to the COVID-19 pandemic. This narrative review aims to explore the impact of COVID-19 on the emergence of mental health problems in high school adolescents. METHODS: This study employed a narrative review method. We conducted a systematic search using PRISMA on three databases: Medline, PubMed, and ScienceDirect. A total of 40 articles met the inclusion and exclusion criteria set based on the research objectives. FINDINGS: The study uncovered that high school adolescents had an increased risk of experiencing mental health problems, namely psychological distress, worry, loneliness, anxiety, depression, traumatic symptoms, other psychological disorders, suicide risk, sleep disorders, and psychosocial functioning. Anxiety, depression, and psychological stress were the most discussed mental health problems among high school adolescents during the COVID-19 pandemic. CONCLUSIONS: There is a need for efforts to identify health problems and intervene in mental health problems early in high school adolescents. Schools, mental health workers, and the government (e.g., policy stakeholders) need to implement the recommendations given as a follow-up effort for mental health services for high school youth.

Widely tunable single-mode slot waveguide quantum cascade laser array.

We report designs and experimental demonstrations of a widely tunable single-mode quantum cascade laser array based on slot waveguide structures in the mid-infrared region. The laser array device realized a continuous tuning range of 71 cm-1 from 9.66 µm to 10.37 µm at 300 K only using the current tuning without any external heatsink temperature adjustments, in good agreement with the design. Stable single-mode operations free of undesired mode-hops have been obtained over the whole tuning range. Another slot waveguide QCL array with a 41 cm-1 continuous tuning range around 7.3 µm has also been realized with the same design principle, demonstrating the universal applicability of the array design. The broadly continuous tuning with simple processing makes the array device a suitable candidate for mid-infrared sensing and spectroscopy application.

An Association Between C-Reactive Protein Levels and the Occurrence of Cognitive Dysfunction After Heart Valve Replacement.

BACKGROUND: Postoperative cognitive dysfunction (POCD) is defined as cognitive dysfunction related to inflammation after surgical procedures, which is common following cardiac surgery. Cognitive deficits are thought to result from a systemic inflammatory response. C-reactive protein (CRP) and other proinflammatory cytokines, which are released in response to inflammation, disrupt the blood-brain barrier and neurotransmission, resulting in POCD. This study aimed to determine the correlation between POCD and increased levels of CRP in patients who had undergone heart valve replacement. METHODS: This study comprised 32 patients with normal cognitive function undergoing heart valve replacement. The CRP levels were measured before surgery and on the second postoperative day, and cognitive function was examined via the Indonesian-adapted Montreal Cognitive Assessment (MOCA-INA) on the third postoperative day. Data were analyzed using Spearman correlation test. RESULTS: Of the 32 patients, 28 (87.5%) experienced POCD. The median level of CRP was 6.6 mg/dL (interquartile range: 4.0, 8.3 g/dL). According to Spearman correlation test, increased levels of CRP were significantly related to POCD following heart valve replacement (p = 0.003, r = 0.501). The receiver operating characteristic curve indicated that the CRP cutoff level was 3.345 mg/dL, and the sensitivity and specificity were 89.3% and 75%, respectively. CONCLUSION: High expression level of CRP was correlated with POCD following heart valve replacement.

Diagnosis and Management of Acquired Hemophilia A: Case Reports and a Literature Review.

BACKGROUND: Acquired hemophilia A (AHA) is a potentially life-threatening autoimmune hemostatic disorder where autoantibodies that disrupt the functions of factor VIII (FVIII) are present in the circulation. The early diagnosis of AHA is difficult since the symptoms of AHA differ from those of congenital hemophilia A. Furthermore, the management of AHA is also more complex due to the presence of autoantibodies against FVIII (FVIII inhibitors). Here, we present three case reports and conduct a literature review of AHA with the aim to increase awareness and knowledge regarding the diagnosis and treatment of AHA. Case Presentations. We present three patients diagnosed with AHA in these case reports. The first patient was a young female, while the second and third patients were middle-aged and elderly males, respectively. All patients presented with a chief complaint of bruises without hemarthrosis and a history of bleeding. Laboratory examinations of the patients revealed isolated prolonged aPTT, normal PT, and the presence of autoantibodies against factor VIII, which are characteristics of AHA. Patients were then treated with corticosteroids to reduce the titer level of autoantibodies and received factor VIII transfusion to stop bleeding. CONCLUSION: AHA can be suspected in patients presenting with symptoms of bruises without hemarthrosis and without the history of bleeding. Isolated aPTT elevation with normal PT should raise high suspicion of AHA. The presence of FVIII inhibitors can help to confirm the diagnosis of AHA. Treatment consists of factor VIII transfusion and corticosteroid therapy. Bypassing agents are recommended as an alternative to FVIII transfusion.

High-performance InGaAs/InAlAs single-photon avalanche diode with a triple-mesa structure for near-infrared photon detection.

We present a novel, to the best of our knowledge, InGaAs/InAlAs single-photon avalanche diode (SPAD) with a triple-mesa structure. Compared with the traditional mesa structures, the horizontal distribution of the electric field decreases dramatically, while the peaks of the electric field at the mesa edges are well eliminated in the triple-mesa structure, leading to an excellent suppression of the surface leakage current and premature breakdown. Furthermore, the temperature coefficient of the breakdown voltage was measured to be as small as 37.4 mV/K within a range from 150 to 270 K. Eventually, one of the highest single-photon detection efficiencies of 35% among all the InGaAs/InAlAs SPADs with a decent dark count rate of ${3.3} \times {{10}^7}\;{\rm Hz}$ was achieved at 240 K. Combined with the inherent ease of integration of the mesa structure, this high-performance triple-mesa InGaAs/InAlAs SPAD provides an effective solution for the fabrication of SPAD arrays and the on-chip integration of quantum systems.

The Role of Chest Radiograph, Procalcitonin and Moxifloxacin in Diagnosis and Management of Breast Cancer Patients with COVID-19.

Global widespread of current coronavirus disease 2019 (COVID-19) pandemic has emerged huge predicament to healthcare systems globally. This disease caused by a new beta-type coronavirus, known as Severe Acute Respiratory Syndrome Coronavirus 2 (SARS-CoV-2), may lead to systemic multiorgan dysfunction syndrome and subsequently cause death due to abundant angiotensin converting enzyme 2 as its functional receptors throughout body. Oncology patients even have a worse prognosis with greater infection susceptibility because they are in a state of suppression of the systemic immune system due to malignancy and anticancer therapy. This problem makes adequate and appropriate treatment urgently needed. Through randomized clinical trials, various drugs were known to have good responses in COVID-19 patients. Here, we reported a-49-year-old-woman that was confirmed for COVID-19 by clinical manifestation, radiology profile, high procalcitonin concentration, and positive polymerase chain reaction (PCR) test. The patient also had breast and thyroid cancers history and had undergone various therapeutic modalities such as chemotherapy, thyroid surgery, and breast surgery. She was undergoing hormone therapy but experiencing disease progression after achieving complete remission based on PET-CT scan 4 months before. The patient was treated with various antibiotics but showed a significant clinical improvement by administering moxifloxacin.

Integration of an InSb photodetector on Si via heteroepitaxy for the mid-infrared wavelength region.

In this study, InSb p-i-n photodetectors with In0.82Al0.18Sb barrier layers were grown on a (100) 6° offcut Si substrate by heteroepitaxy via an AlSb/GaSb buffer. Based on an interfacial misfit array growth mode, the dislocations at the GaSb/Si and InSb/AlSb interfaces accommodated the lattice mismatch. The In0.82Al0.18Sb barrier layer increased the 77 K R0A of the detector. From 180 K to 300 K, the generation-recombination mechanism dominated the dark current generation in the detector and surface leakage became dominant below 120 K. The detector exhibited a 77 K responsivity of 0.475 A/W and a Johnson-noise-limited detectivity of 3.08 × 109 cmHz1/2W-1 at 5.3 µm.

Integration of InGaAs MOSFETs and GaAs/ AlGaAs lasers on Si Substrate for advanced opto-electronic integrated circuits (OEICs).

Lasers monolithically integrated with high speed MOSFETs on the silicon (Si) substrate could be a key to realize low cost, low power, and high speed opto-electronic integrated circuits (OEICs). In this paper, we report the monolithic integration of InGaAs channel transistors with electrically pumped GaAs/AlGaAs lasers on the Si substrate for future advanced OEICs. The laser and transistor layers were grown on the Si substrate by molecular beam epitaxy (MBE) using direct epitaxial growth. InGaAs n-FETs with an ION/IOFF ratio of more than 106 with very low off-state leakage and a low subthreshold swing with a minimum of 82 mV/decade were realized. Electrically pumped GaAs/AlGaAs quantum well (QW) lasers with a lasing wavelength of 795 nm at room temperature were demonstrated. The overall fabrication process has a low thermal budget of no more than 400 °C.

Monolithic integration of InGaAs n-FETs and lasers on Ge substrate.

We report the first monolithic integration of InGaAs channel field-effect transistors with InGaAs/GaAs multiple quantum wells (MQWs) lasers on a common platform, achieving a milestone in the path of enabling low power and high speed opto-electronic integrated circuits (OEICs). The III-V layers used for realizing transistors and lasers were grown epitaxially on the Ge substrate using molecular beam epitaxy (MBE). A Si-CMOS compatible process was developed to realize InGaAs n-FETs with subthreshold swing SS of 93 mV/decade, ION/IOFF ratio of more than 4 orders of magnitude with very low off-state leakage current, and a peak effective mobility of more than 2000 cm2/V·s. In addition, fabrication process uses a low overall processing temperature (≤ 400 °C) to maintain the high quality of the InGaAs/GaAs MQWs for the laser. Room temperature electrically-pumped lasers with a lasing wavelength of 1.03 µm and a linewidth of less than 1.7 nm were realized.