Cephalometric Soft Tissue Morphology of Adults With Unoperated Submucous Cleft Palate.

The aim of this study was to compare craniofacial soft tissue characteristics between subjects with unrepaired submucous cleft palate (SMCP) and noncleft individuals.This retrospective cross-sectional study was performed on 27 subjects with unrepaired SMCP (13 male and 14 female subjects; mean age, 21.77 ± 4.09 years) and 30 noncleft controls (14 male and 16 female subjects; mean age, 22.67 ± 4.28 years). The predictor variable was cleft deformity. The outcome variable was cephalometric soft tissue measurements. Other study variables were gender and age. Independent samples t test and Mann-Whitney U test were used for intergroup comparison. P value was set at .05.Significant differences were observed in the facial profile angle, total facial profile angle, soft tissue A-N-B angle, nasal base prominence, upper lip length, lower lip protrusion, and the ratio of upper lip length to mentolabial height between subjects with unoperated SMCP and noncleft controls.The primary deformity of the cleft palate leads to unsatisfactory facial soft tissue morphology, especially in the middle facial region.

Utilization of Marine Waste to Obtain ß-Chitin Nanofibers and Films from Giant Humboldt Squid Dosidicus gigas.

ß-chitin was isolated from marine waste, giant Humboldt squid Dosidicus gigas, and further converted to nanofibers by use of a collider machine under acidic conditions (pH 3). The FTIR, TGA, and NMR analysis confirmed the efficient extraction of ß-chitin. The SEM, TEM, and XRD characterization results verified that ß-chitin crystalline structure were maintained after mechanical treatment. The mean particle size of ß-chitin nanofibers was in the range between 10 and 15 nm, according to the TEM analysis. In addition, the ß-chitin nanofibers were converted into films by the simple solvent-casting and drying process at 60 °C. The obtained films had high lightness, which was evidenced by the CIELAB color test. Moreover, the films showed the medium swelling degree (250-290%) in aqueous solutions of different pH and good mechanical resistance in the range between 4 and 17 MPa, depending on film thickness. The results obtained in this work show that marine waste can be efficiently converted to biomaterial by use of mild extractive conditions and simple mechanical treatment, offering great potential for the future development of sustainable multifunctional materials for various industrial applications such as food packaging, agriculture, and/or wound dressing.

What operative or anatomic factors affect dental arch development in the cleft patient?

PURPOSE: There has been dispute about the exact factors influencing dental arch development in adult cleft palate patients, so we designed this study to investigate the effects of operative and anatomic factors on the development of dental arch morphology. PATIENTS AND METHODS: A retrospective cohort study was conducted among 3 groups of patients (operated, unoperated, and normal) from West China College of Stomatology, Sichuan University, Chengdu, China. The differences in dental arch morphology, including length and width of the upper and lower dental arches, inclination of the palatal shelf, and palatal height, were analyzed by variance analysis with SPSS software, version 13.0 (IBM, Armonk, NY). RESULTS: We enrolled 90 individuals: 30 unoperated adults with bilateral cleft lip and palate, 30 adults with operated bilateral cleft lip and palate, and 30 normal adults. The widths of all upper and posterior lower arches, lengths of the anterior upper arch, palatal height, and palatal shelf inclination in the operated group were smaller than those in the unoperated group; the lengths and widths of the anterior upper arch were smaller whereas the widths of the posterior upper and lower arches, palatal height, and palatal shelf inclination were greater in the unoperated group compared with the normal group. CONCLUSIONS: Operated cleft patients show the most severe deformation of the maxillary arch, especially in the anterior part. There is an intrinsic palatal tissue deficiency in cleft patients, whereas the maxillary arch deformation in unoperated cleft patients is limited to the anterior region only.

Evaluation of Postoperative Outcomes in Two Cleft Palate Repair Techniques without Relaxing Incisions.

BACKGROUND: A modified palatoplasty was established by incorporating the designs of both Sommerlad and Furlow techniques in addition to a novel incision on the medial pterygoid plate's surface, named the Sommerlad-Furlow modified technique. Thus, this study aimed to evaluate the clinical and functional outcomes of the Sommerlad-Furlow modified technique against an accepted standard, the Furlow technique. METHODS: A retrospective review was conducted for 212 consecutive nonsyndromic cleft palate patients who underwent Sommerlad-Furlow ( n = 106) and Furlow ( n = 106) repairs without relaxing incision on the hard palate between 2011 and 2016. The success of surgical procedures was estimated by the rate of postoperative fistula, speech outcomes, and velopharyngeal insufficiency (VPI)-related quality of life. The demographic and surgical data, including sex, age, cleft type, cleft width, and follow-up period were recorded. RESULTS: There was no statistically significant difference between the two treatment groups regarding demographic and surgical data, except the cleft width ( P < 0.001). The incidence of the fistula was 7.5% and 6.6% after the Sommerlad-Furlow and Furlow procedures, respectively. The two groups showed no significant differences in speech outcomes, and adequate velopharyngeal function was found in 84% and 82.1% in Sommerlad-Furlow and Furlow procedures, respectively. Besides, the rate of severe VPI was slightly lower in Sommerlad-Furlow (0.9%) than in Furlow (2.8%) procedures. Moreover, an adequate VPI-related quality of life was found in 80.4% of the Sommerlad-Furlow group and 78.6% of the Furlow group. CONCLUSION: The Sommerlad-Furlow technique has obtained acceptable postoperative outcomes and could be a choice for cleft palate repair, especially in wider clefts. CLINICAL QUESTION/LEVEL OF EVIDENCE: Therapeutic, III.

ChatGPT for shaping the future of dentistry: the potential of multi-modal large language model.

The ChatGPT, a lite and conversational variant of Generative Pretrained Transformer 4 (GPT-4) developed by OpenAI, is one of the milestone Large Language Models (LLMs) with billions of parameters. LLMs have stirred up much interest among researchers and practitioners in their impressive skills in natural language processing tasks, which profoundly impact various fields. This paper mainly discusses the future applications of LLMs in dentistry. We introduce two primary LLM deployment methods in dentistry, including automated dental diagnosis and cross-modal dental diagnosis, and examine their potential applications. Especially, equipped with a cross-modal encoder, a single LLM can manage multi-source data and conduct advanced natural language reasoning to perform complex clinical operations. We also present cases to demonstrate the potential of a fully automatic Multi-Modal LLM AI system for dentistry clinical application. While LLMs offer significant potential benefits, the challenges, such as data privacy, data quality, and model bias, need further study. Overall, LLMs have the potential to revolutionize dental diagnosis and treatment, which indicates a promising avenue for clinical application and research in dentistry.

[Fabrication of tissue engineered vein containing valve scaffolds].

OBJECTIVE: To fabricate porous biodegradable tissue engineered vein containing valve scaffolds. METHODS: Based on the self-made cast, the tissue engineered vein containing valve scaffolds was fabricated by injection molding plus thermally induced phase separation. Poly (lactic-co-glycolic acid) (PLGA, LA/GA mole ratio 75:25) was used as matrices. Morphological structures and biocompatibility of scaffolds were tested. Cell seeding on scaffold was performed and the mechanic characteristics of cellular constructs evaluated. RESULTS: The scaffold had an inner diameter of 9 mm with a wall thickness of 0.9 mm and the thickness of valves was (0.32 ± 0.04) mm. Scanning electron microscopic (SEM) micrographs showed regular ladder-like porous structures and the average pore size and porosity of scaffolds were 10 - 20 µm and 90%. The PLGA scaffolds were biocompatible. The cellular constructs were tested in vitro, and the valve leaflets were functionally capable of opening and closing when stimulated. CONCLUSION: Based on the self-made cast, the tissue engineered vein containing valve scaffolds can be fabricated by injection molding plus thermally induced phase separation. Further researches are warranted.

Advances in lytic polysaccharide monooxygenases with the cellulose-degrading auxiliary activity family 9 to facilitate cellulose degradation for biorefinery.

One crucial step in processing the recalcitrant lignocellulosic biomass is the fast hydrolysis of natural cellulose to fermentable sugars that can be subsequently converted to biofuels and bio-based chemicals. Recent studies have shown that lytic polysaccharide monooxygenase (LPMOs) with auxiliary activity family 9 (AA9) are capable of efficiently depolymerizing the crystalline cellulose via regioselective oxidation reaction. Intriguingly, the catalysis by AA9 LPMOs requires reductant to provide electrons, and lignin and its phenolic derivatives can be oxidized, releasing reductant to activate the reaction. The activity of AA9 LPMOs can be enhanced by in-situ generation of H2O2 in the presence of O2. Although scientific understanding of these enzymes remains somewhat unknown or controversial, structure modifications on AA9 LPMOs through protein engineering have emerged in recent years, which are prerequisite for their extensive applications in the development of cellulase-mediated lignocellulosic biorefinery processes. In this review, we critically comment on advances in studies for AA9 LPMOs, i.e., characteristic of AA9 LPMOs catalysis, external electron donors to AA9 LPMOs, especially the role of the oxidization of lignin and its derivatives, and AA9 LPMOs protein engineering as well as their extensive applications in the bioprocessing of lignocellulosic biomass. Perspectives are also highlighted for addressing the challenges.

Magnetic resonance imaging assessment of velopharyngeal structures in Chinese children after primary palatal repair.

BACKGROUND: Velopharyngeal inadequacy (VPI) after primary palatal repair remains a persistent problem despite advanced surgical techniques. Velopharyngeal inadequacy has significant negative impacts on patients' speech intelligibility and quality. Previous studies have produced conflicting results regarding the causes of VPI, which are likely due to limitations in two-dimensional imaging techniques used as well as failure to include matched groups with repaired cleft palate and differing velopharyngeal outcome. The present study aimed to investigate the characteristics of the velopharyngeal structures, including the levator veli palatini muscles, in children with repaired cleft palate and different speech outcomes. METHODS: A prescan training was performed to help the child participants to finish scans successfully without general anesthesia. Multiple high-resolution magnetic resonance imaging scans covering the whole head and focusing on the velopharyngeal region, including the levator veli palatini muscles, were acquired in 3 matched groups of young children: children with cleft palate and VPI, children with cleft palate and adequate velopharyngeal closure, and children without cleft palate. RESULTS: There were few significant differences between the 2 groups with cleft palate, although the functional pharyngeal dimensions were slightly greater in the children with VPI. More significant differences were found between the children with cleft palate and the control subjects. CONCLUSIONS: Anatomic characteristics of the velopharyngeal structures may be slightly less advantageous for velopharyngeal closure in children with VPI after palatal repair, but these structural differences alone cannot explain VPI.

ROS-Responsive Polymeric Micelle for Improving Pesticides Efficiency and Intelligent Release.

The low utilization rate of pesticides causes serious problems such as food safety and environmental pollution. Stimulus-responsive release can effectively improve the utilization rate of pesticides. Reactive oxygen species (ROS) burst, as an early event of plant-pathogen interaction, can stimulate the release of pesticides. In this work, a polymeric micelle with ROS-responsive was prepared and then Validamycin (Vail) was loaded into polymeric micelle to prepare Vail-loaded polymeric micelle. The Vail-loaded polymeric micelle displayed excellent ROS-dependent release kinetics. In vitro and in vivo antifungal experiments confirmed that the Vail-loaded polymeric micelle could improve antifungal efficacy against Rhizoctonia solani than with the Vail reagent. Therefore, as a biostimulation and controlled release system, ROS-responsive polymeric micelles can improve the utilization rate of pesticides and alleviate the problem of food safety and environmental pollution.

Distinct Interaction of Lytic Polysaccharide Monooxygenase with Cellulose Revealed by Computational and Biochemical Studies.

A distinct interaction pattern of lytic polysaccharide monooxygenases (LPMOs) with their insoluble substrate, cellulose, was revealed through the combination of computational and biochemical approaches. The results indicated that the enzymes can stably bind on the flat hydrophobic surface of cellulose via the interactions of the key residues located in the axis across the conserved distal tyrosine residue and copper ion with two adjacent cellulose chains. Further studies on the correlation of substrate binding and H2O2 accumulation suggested that LPMOs involved in the productive binding on the insoluble polysaccharides not only fail to accumulate H2O2 but also consume the H2O2 produced by the unbound molecules under the lab condition. This was further substantiated by quantum-mechanical calculations. These findings broadened our knowledge of the interaction between enzymes and insoluble substrates and deepened our understanding of the role that H2O2 plays in LPMO activity.

A lytic polysaccharide monooxygenase from Myceliophthora thermophila and its synergism with cellobiohydrolases in cellulose hydrolysis.

Lytic polysaccharide monooxygenases (LPMOs) have attracted vast attention because of their unique mechanism of oxidative degradation of carbohydrate polymers and the potential application in biorefineries. This study characterized a novel LPMO from Myceliophthora thermophila, denoted MtLPMO9L. The structure model of the enzyme indicated that it belongs to the C1-oxidizing LPMO, which has neither an extra helix in the L3 loop nor extra loop region in the L2 loop. This was confirmed subsequently by the enzymatic assays since MtLPMO9L only acts on cellulose and generates C1-oxidized cello-oligosaccharides. Moreover, synergetic experiments showed that MtLPMO9L significantly improves the efficiency of cellobiohydrolase (CBH) II. In contrast, the inhibitory rather than synergetic effect was observed when combining used MtLPMO9L and CBHI. Changing the incubation time and concentration ratio of MtLPMO9L and CBHI could attenuate the inhibitory effects. This discovery suggests a different synergy detail between MtLPMO9L and two CBHs, which implies that the composition of cellulase cocktails may need reconsideration.

Influence of different palate repair protocols on facial growth in unilateral complete cleft lip and palate.

OBJECTIVE: To address the question of whether one- or two-stage palatal treatment protocol has fewer detrimental effects on craniofacial growth in patients aged 5 years with unilateral complete cleft lip and palate. MATERIALS AND METHODS: Forty patients with non-syndromic unilateral complete cleft lip and palate (UCCLPs) who had received primary cleft lip repair at age 6-12 months and cleft palate repair at age 18-30 months were selected in this study. Eighteen UCCLP patients who received two-stage palate repair were selected as group 1, and 22 UCCLP patients who received one-stage palate repair were selected as group 2. The control group consisted of 20 patients with unilateral incomplete cleft lip (UICL patients) whose age and gender matched with UCCLP patients. A one-sample Kolmogorov-Smirnov test was used to analyze the nature of data distribution. Bonferroni test and Kruskal-Wallis H tests were used for multiple comparisons. RESULTS: Both case groups showed reduced maxillary sagittal length (ANS-PMP, A-PM, p < 0.05) and retrusion of the maxilla (S-Ptm, p < 0.05), A point and ANS point (Ba-N-A, Ba-N-ANS, p < 0.05). Patients treated with two-stage palate repair had a reduced posterior maxillary vertical height (R-PMP, p < 0.05). CONCLUSIONS: Our results indicated that maxillary sagittal length and position could be perturbed by both one- and two-stage palate repair. Vomer flap repair inhibited maxilla vertical growth. Delayed hard palate repair showed less detrimental effects on maxillary growth compared to early hard palate repair in UCCLP patients aged 5 years.

Analysis of the correlative factors for velopharyngeal closure of patients with cleft palate after primary repair.

OBJECTIVE: The objective of this study was to analyze the correlative factors for velopharyngeal closure of patients with cleft palate after primary repair. STUDY DESIGN: Ninety-five nonsyndromic patients with cleft palate were enrolled. Two surgical techniques were applied in the patients: simple palatoplasty and combined palatoplasty with pharyngoplasty. All patients were assessed 6 months after the operation. The postoperative velopharyngeal closure (VPC) rate was compared by χ(2) test and the correlative factors were analyzed with logistic regression model. RESULTS: The postoperative VPC rate of young patients was higher than that of old patients, the group with incomplete cleft palate was higher than the group with complete cleft palate, and combined palatoplasty with pharyngoplasty was higher than simple palatoplasty. Operative age, cleft type, and surgical technique were the contributing factors for postoperative VPC rate. CONCLUSIONS: Operative age, cleft type, and surgical technique were significant factors influencing postoperative VPC rate of patients with cleft palate.

Alginate oligosaccharides enhanced Triticum aestivum L. tolerance to drought stress.

Alginate oligosaccharides (AOS) prepared from degradation of alginate is a potent plant elicitor. Hydroponic experiments were carried out to investigate the mechanism of AOS on improving Triticum aestivum L. resistant ability to drought stress. Drought model was simulated by exposing the roots of wheat to polyethylene glycol-6000 (PEG-6000) solution (150 g L(-1)) for 4 days and the growth of wheat treated with PEG was significantly decreased. However, after AOS application, seedling and root length, fresh weight and relative water content of wheat were increased by 18%, 26%, 43% and 33% under dehydration status compared with that of PEG group, respectively. Moreover, the antioxidative enzymes activities were obviously enhanced and malondialdehyde (MDA) content was reduced by 37.9% in samples treated by AOS. Additionally, the drought resistant related genes involved in ABA signal pathway, such as late embryogenesis abundant protein 1 gene (LEA1), psbA gene, Sucrose non-fermenting 1-related protein kinase 2 gene (SnRK2) and Pyrroline-5-Carboxylate Synthetase gene (P5CS) were up-regulated by AOS. Our results suggested that AOS might regulate ABA-dependent signal pathway to enhance drought stress resistance of wheat during growth period.

[Assessment of the mechanical properties and biocompatibility of a new electrospun polyurethane vascular prosthesis].

OBJECTIVE: To develop a small-caliber vascular grafts and study its morphologies, mechanical properties and biocompatibility. METHODS: The effects of electrospinning conditions on the microstructure and porosity of the resulting scaffolds were investigated for preparation of a small-caliber (4 mm) polyurethane vascular grafts with optimum microstructures and mechanical properties. The mechanical properties and biocompatibility of the prepared grafts were evaluated. RESULTS: The polyurethane vascular grafts showed a three-dimensional reticular structure consisting of nanofibers, with an average porosity of (51.48∓4.47)% and tensile strength of 5.85 ∓ 0.62 MPa. The grafts provided a better long-term support than e-PTFE graft for endothelial cell growth and endothelialization. CONCLUSION: The polyurethane vascular prosthesis possessed favorable microstructures, excellent mechanical properties and good biocompatibility for potential clinical application.

[Error analysis of functional articulation disorders in children].

OBJECTIVE: To explore the clinical characteristic of functional articulation disorders in children and provide more evidence for differential diagnosis and speech therapy. METHODS: 172 children with functional articulation disorders were grouped by age. Children aged 4-5 years were assigned to one group, and those aged 6-10 years were to another group. Their phonological samples were collected and analyzed. RESULTS: In the two groups, substitution and omission (deletion) were the mainly articulation errors in these children, dental consonants were the main wrong sounds, and bilabial and labio-dental were rarely wrong. In age 4-5 group, sequence according to the error frequency from the highest to lowest was dental, velar, lingual, apical, bilabial, and labio-dental. In age 6-10 group, the sequence was dental, lingual, apical, velar, bilabial, labio-dental. Lateral misarticulation and palatalized misarticulation occurred more often in age 6-10 group than age 4-5 group and were only found in lingual and dental consonants in two groups. CONCLUSION: Misarticulation of functional articulation disorders mainly occurs in dental and rarely in bilabial and labio-dental. Substitution and omission are the most often occurred errors. Lateral misarticulation and palatalized misarticulation occur mainly in lingual and dental consonants.

[Study on the effects of different extent of cleft malformation on speech in patients with cleft palate].

OBJECTIVE: To investigate the relation between different extents of cleft malformation with the speech characteristics in patients with cleft palate. METHODS: The formant frequency of vowel [i] of 46 incomplete cleft palate patients (ICCP group) and 56 complete cleft palate patients (CCP group) before and after cleft palate repair, as well as 30 normal people (C group), were measured and analyzed on spectrogram. RESULTS: The comparison of F1 between C group and CCP, ICCP before surgery showed no difference. So did the comparison of F1 between C group and CCP, ICCP after surgery. The comparison of F2 between C group and CCP, ICCP before surgery showed significant difference. The value of the C group was the highest. The value of the ICCP was higher than that of CCP. So did the comparison of F2 between C group and CCP, ICCP after surgery. The comparison of F3 between C group and CCP, ICCP(including before and after surgery) was similar to the results of F2 between the three groups. The comparison of F1 between before and after surgery in ICCP group showed no difference. However, the same kind of comparison of F2 and F3 showed significant differences: Both the values after surgery were higher than those before surgery. The comparison of Fl, F2 and F3 between before and after surgery in CCP group was similar to that in ICCP group. CONCLUSION: The extent of the cleft malformation is closely related to the status of the speech in patients with cleft palate. With the malformation more severe, the tongue will move backward more obviously, the elevation of the soft palate after cleft palate repair will be less active. Two ways are recommended for those patients with CCP: (1) Early interceptive orthodontic treatment to reduce the extent of palate malformation; (2) The hard palate repair can be performed prior to the soft palate repair. Patients with severe cleft lip and palate can have hard palate repaired while accepting the early cleft lip repair.

[Experimental study of a polypropylene mesh for moulding and supporting a breast during a breast reduction procedure].

OBJECTIVE: To study the polypropylene mesh acted for the moulding and support. METHODS: Four mini-pigs were used in this experimental research. A polypropylene mesh was implanted under the skin on one side of each pig. An expander was thereafter placed in the deep layer to imitate the action of gravity to the skin and mesh. The specimens were collected in two different times for the biomechanics and histology examinations. RESULTS: The biomechanical data were shown lower and the histological properties were found changeable in the expanded skin without the mesh support, compared with the normal skin. However, the changes did not occur in the expanded skin with the mesh support. Furthermore, the tensile strength and elastic modulus of the polypropylene mesh were significant less than the human skin. CONCLUSION: The Polypropylene mesh could prevent the extended skin effectively and has moulding and support effects.