Differentiating the impact of fine and coarse particulate matter on cause-specific cerebrovascular mortality: An individual-level, case-crossover study.

BACKGROUND AND OBJECTIVES: Many studies suggested that short-term exposure to fine particulate matter (PM2.5) and coarse particulate matter (PM2.5-10) was linked to elevated risk of cerebrovascular disease. However, little is known about the potentially differential effects of PM2.5 and PM2.5-10 on various types of cerebrovascular disease. METHODS: We collected individual cerebrovascular death records for all residents in Shanghai, China from 2005 to 2021. Residential daily air pollution data were predicted from a satellite model. The associations between particulate matters (PM) and cerebrovascular mortality were investigated by an individual-level, time-stratified, case-crossover design. The data was analyzed by the conditional logistic regression combined with the distributed lag model with a maximum lag of 7 days. Furthermore, we explored the effect modifications by sex, age and season. RESULTS: A total of 388,823 cerebrovascular deaths were included. Monotonous increases were observed for mortality of all cerebrovascular diseases except for hemorrhagic stroke. A 10 µg/m3 rise in PM2.5 was related to rises of 1.35% [95% confidence interval (CI): 1.04%, 1.66%] in mortality of all cerebrovascular diseases, 1.84% (95% CI: 1.25%, 2.44%) in ischemic stroke, 1.53% (95% CI: 1.07%, 1.99%) in cerebrovascular sequelae and 1.56% (95% CI: 1.08%, 2.05%) in ischemic stroke sequelae. The excess risk estimates per each 10 µg/m3 rise in PM2.5-10 were 1.47% (95% CI: 1.10%, 1.84%), 1.53% (95% CI: 0.83%, 2.24%), 1.93% (95% CI: 1.38%, 2.49%) and 2.22% (95% CI: 1.64%, 2.81%), respectively. The associations of both pollutants with all cerebrovascular outcomes were robust after controlling for co-pollutants. The associations were greater in females, individuals > 80 years, and during the warm season. CONCLUSIONS: Short-term exposures to both PM2.5 and PM2.5-10 may independently increase the mortality risk of cerebrovascular diseases, particularly of ischemic stroke and stroke sequelae.

Alveolar bone loss and tooth loss contribute to increase in cancer mortality among older patients.

BACKGROUND: Both cancer and periodontitis are more prevalent with age. Information on their relationship in older patients is limited. This study aims to examine whether periodontitis is associated with increased risk of cancer mortality with a ≥ 75-year age group cohort. METHODS: A retrospective cohort study was conducted on 1146 patients who had digital radiographic examinations. Alveolar bone loss and loss of teeth were measured as indicators of periodontitis. Hazard ratio (HR) with 95% confidence interval (CI) were taken as the effect size to summarize the associations between periodontitis and risks of cancer mortality using the multivariate adjusted cox proportional hazards model and competing risk hazard model. RESULTS: Totally, 104 total cancer, 28 lip, oral cavity and pharynx (LOP) cancer, 39 digestive cancer and 13 respiratory cancer cases were documented over 10 years of follow-up. Total cancer (HR 1.27, 95% CI 1.06-1.53) displayed statistically significant associations with alveolar bone loss and tooth loss after adjusting for relevant confounding variables. We also observed borderline significant association between alveolar bone loss and LOP cancer (HR 1.45, 95% CI 0.99-2.12). The above associations were consistent with the results observed from the competing risk hazard models. CONCLUSION: Our results indicate that older patients suffering from tooth loss or alveolar bone loss are at increased risks of cancer mortality, especially for total cancer and LOP cancer.

Residential Nitrogen Dioxide Exposure and Cause-Specific Cerebrovascular Mortality: An Individual-Level, Case-Crossover Study.

BACKGROUND: Existing studies have already shown a connection between nitrogen dioxide (NO2) exposure and cerebrovascular mortality. However, the differential effects of NO2 on cerebrovascular disease and its subtypes remain unclear and require further exploration. METHODS: Daily stroke mortality data between 2013 and 2021 in Shanghai, China were collected. Residential daily air pollution data for each decedent were predicted from a satellite model. An individual-level, time-stratified, case-crossover design was applied to examine the relationship between NO2 exposure and cerebrovascular mortality. A combination of conditional logistic regression and distributed lag models with a maximum lag of 7 days was used for data analysis. RESULTS: A total of 219,147 cases of cerebrovascular mortality were recorded. Among them, the proportion of sequelae of cerebrovascular disease, hemorrhagic stroke and ischemic stroke was 50.7%, 17.1% and 27.5%, respectively. The monotonic increases in mortality risks of cerebrovascular diseases, sequelae of cerebrovascular disease and ischemic stroke were observed, without any discernible thresholds. Each 10 µg/m3 increase in NO2 concentration was associated with increments of 3.62% [95% confidence interval (CI): 2.56%, 4.69%] for total cerebrovascular mortality, 4.29% (95% CI: 2.81%, 5.80%) for sequelae of cerebrovascular disease mortality and 4.30% (95% CI: 2.30%, 6.33%) for ischemic stroke mortality. No positive associations between NO2 exposure and hemorrhagic stroke mortality were observed. A greater risk of NO2 was observed in the warm season, in patients with less than 9 years of education and in those with single marital status. The effects of NO2 were robust to mutual adjustment of co-pollutants. CONCLUSIONS: Short-term exposures to NO2 may increase the risk of cerebrovascular mortality, specifically for ischemic stroke and sequelae of cerebrovascular disease.

Mandibular stability and condylar changes following orthognathic surgery in mandibular hypoplasia patients associated with preoperative condylar resorption.

OBJECTIVES: To evaluate postoperative mandibular stability and condylar changes in patients with mandibular hypoplasia and preoperative condylar resorption (CR) undergoing orthognathic surgery. MATERIALS AND METHODS: Fifty-four patients were included in this retrospective study. Computed tomography (CT) scans were acquired preoperatively (T0), 2-7 days immediate postoperatively (T1), and at least 1 year postoperatively (T2). Three-dimensional (3D) cephalometric analysis and measurements of condylar angle, volume, and position (joint spaces) were performed. A 2-mm mandibular relapse was deemed clinically acceptable. We also analyzed the correlations between relapse and postoperative CR and susceptible factors using a multivariate logistic regression model. RESULTS: The results showed one year after the surgery, the average mandibular relapse was 1.0 mm (p < 0.05), and the average reduction of condylar volume was 152.4 mm3 (12.7%). Condyle-fossa relationships were improved immediately after the surgery, with a tendency of returning to their original state in the follow-up (p < 0.05). Anteroposterior advancement at point B (B-CP advancement) at T1 and superior joint space (SJS) at T0 were significantly correlated with mandibular relapse, and postoperative CR was mainly associated with vertical increasement at point B (B-AP increasement) at T1. The optimal cut-off values were as follows: 1.6 mm for SJS, 4.2 mm for B-CP advancement, and 1.8 mm for B-AP increasement. Concomitant advancement Genioplasty showed no significant correlation with relapse and postoperative CR. CONCLUSIONS: While patients with mandibular hypoplasia and preoperative CR were vulnerable to further condylar resorption after mandibular advancement, the treatment outcomes were generally clinically acceptable. Postoperative relapse was associated with a larger than 4.2 mm of mandibular advancement measured at B-CP and a larger than 1.6 mm of superior joint space measured at SJS, and postoperative CR was associated with a larger than 1.8 mm of mandibular vertical increasement measured at B-AP. CLINICAL RELEVANCE: The findings of this study suggested that the mandibular advancement might be limited to 5 mm for patients with preoperative CR. A concomitant advancement genioplasty might also be considered to achieve a better facial profile in these patients.

A random forest algorithm predicting model combining intraoperative frozen section analysis and clinical features guides surgical strategy for peripheral solitary pulmonary nodules.

Background: Intraoperative frozen section (FS) analysis has been used to guide the extent of resection in patients with solitary pulmonary nodules (SPNs), but its accuracy varies greatly among different hospitals. Artificial intelligence (AI) and multidimensional data technology are developing rapidly these years, meanwhile, surgeons need better methods to guide the surgical strategy of SPNs. We established predicting models combining FS results with multidimensional perioperative clinical features using logistic regression analysis and the random forest (RF) algorithm to get more accurate extent of SPN resection. Methods: Patients with peripheral SPNs who underwent FS-guided surgical resection at the Shanghai Chest Hospital (January 2017-December 2018) were retrospectively examined (N=3,089). The accuracy of intraoperative FS-guided resection extent was analyzed and used as Model 1. The clinical features (sex, age, CT features, tumor markers, smoking history, lesion size and nodule location) of patients were collected, and Models 2 and 3 were established using logistic regression and RF algorithms to combine the FS with clinical features. We confirmed the performance of these models in an external validation cohort of 117 patients from Hwa Mei Hospital, University of Chinese Academy of Science (Ningbo No. 2 Hospital). We compared the effectiveness in classifying low/high-risk groups of SPN among them. Results: The accuracy of FS analysis was 61.3%. Model 3 exhibited the best diagnostic accuracy and had an area under the curve of 0.903 in n the internal validation cohort and 0.919 in the external validation cohort. The calibration plots and net reclassification index (NRI) of Model 3 also exhibited significantly better performance than the other models. Improved diagnostic accuracy was observed in in both internal and external validation cohort. Conclusions: Using an RF algorithm, clinical characteristics can be combined with intraoperative FS analysis to significantly improve intraoperative judgment accuracy for low- and high-risk tumors, and may serve as a reliable complementary method when FS evaluation is equivocal, improving the accuracy of the extent of surgical resection.

Evaluation of Related Factors of Maxillary Sinusitis After Le Fort I Osteotomy Based on Computed Tomography: A Retrospective Case-Control Study.

ABSTRACT: Maxillary sinusitis is 1 of the postoperative complications of the Le Fort I osteotomy, this study investigated the related factors of maxillary sinusitis after Le Fort I osteotomy. A total of 23 cases, 92 controls, and 11 related factors were included in this case-control study with a 1:4 case-control ratio. The risk factors for maxillary sinusitis after Le Fort I were examined by least absolute shrinkage and selection operator multivariate conditional logistic regression and least absolute shrinkage and selection operator multivariate linear regression. The patency of maxillary sinus ostium at 6 months after surgery was significantly associated with maxillary sinusitis after Le Fort I osteotomy. Compared with the obstructed maxillary sinus ostium, the percentage of the volume of the healthy air cavity in the complete sinus cavity increased 70.7% when the maxillary sinus ostium was unobstructed, and 95% confidence interval was 0.610 to 0.805. Similarly, when the maxillary sinus ostium was wide, the percentage increased 6.0% compared with the narrow 1, and 95% confidence interval was 0.013 to 0.107. This study indicated that the patency of maxillary sinus ostium has an important impact on maxillary sinusitis after Le Fort I osteotomy. Close attention should be paid to maintain the maxillary sinus ostium and the drainage of maxillary sinuses unobstructed in a clinical setting.

Effects of long-term soft contact lens wear on corneal epithelial thickness after small incision lenticule extraction.

The present study investigated changes in corneal epithelial thickness after small incision lenticule extraction (SMILE) in patients with long-term preoperative soft contact lens (SCL) wear, the impact of SCL wear on the efficacy of surgical outcomes and the effects of long-term SCL wear on postoperative corneal aberrations. Patients were assigned to three groups according to the duration of SCL wear: Group A, the non-SCL-wearing group; group B, those with SCL wear ≤1 year; and group C, those with SCL wear >1 year. Epithelial thickness was recorded in nine zones by anterior segment optical coherence tomography across a 5-mm diameter before surgery and at 1 week, and 1, 3 and 6 months post-surgery. Corneal epithelial thickness and corneal aberrations among the three groups were compared, as well as the effects of changes in corneal epithelial thickness on postoperative visual acuity and manifest refraction. No significant differences were noted with regard to age or preoperative spherical equivalent among groups A (22 eyes), B (17 eyes) and C (18 eyes). Preoperative corneal epithelial thickness in the inferonasal, inferior and inferotemporal zones was thinner in group B compared with that in group A, and corneal epithelial thickness was thinner in all nine zones in group C compared with that in group A (P<0.05). At all follow-up time points, in the central, nasal, inferonasal, inferior, inferotemporal and temporal areas, the epithelial thickness was thinner in group C compared with that in group A (P<0.05). At 3 months postoperatively, the epithelial thickness was thinner in the inferonasal and inferior sectors in group C compared with that in group B (P<0.05), and at 6 months postoperatively, the epithelial thickness in the inferior region was thinner in group C compared with that in group B (P<0.05). There were no significant differences in visual acuity or manifest refraction among the three groups at all postoperative time points. The total higher-order aberrations were greater in group C compared with those in group A for all time points (P<0.05) and were greater in group C at 1 and 3 months postoperatively compared with those in group B (P<0.05). The spherical aberrations at 3 and 6 months postoperatively were greater in group C compared with those in group A (P<0.05). The coma aberrations were greater in group C compared with those in groups A and B for all time points (P<0.05). In conclusion, long-term SCL wear will result in corneal epithelial thinning, which does not impact visual acuity or manifest refraction after SMILE.

Low ambient temperature as a novel risk factor of oral diseases: A time-series study.

BACKGROUND: The seasonal variation of oral diseases has been observed in life, but the influences of oral diseases associated with non-optimal ambient temperature were unknown. OBJECTIVE: To examine whether non-optimum ambient temperature is associated with increased risks of oral diseases. METHODS: We conducted a time series study based on outpatient data from the Shanghai Health Information Center, containing all public hospitals in Shanghai from 2016 to 2019. Generalized additive models with distributed lagged nonlinear models were applied to fit the data. RESULT: A total of 3,882,636 outpatient cases of oral diseases were collected. Low temperature (<7 °C) posed increased risks for oral diseases. Daily temperature above 7 °C had no effect on oral diseases. The excess risks were present on the lag 1 day and lasted till lag 7 day. Relative to referent temperatures, the cumulative risks of total oral diseases, pulpitis, periodontitis, gum pain, stomatitis, and glossitis at extreme low temperature (-3 °C, 1st percentile) over lag 0-7 day were 1.92 (95% confidence interval, CI: 1.40, 2.63), 2.40 (95% CI: 1.78, 3.25), 1.62 (95% CI: 1.15, 2.29), 1.75 (95% CI: 1.08, 2.83), 1.81 (95% CI: 1.30, 2.53), and 2.22 (95% CI: 1.23, 3.99). These associations were larger in patients who were above age 60. CONCLUSION: This study provided novel epidemiological evidence that low ambient temperature may increase the risks of oral diseases. The temperature thresholds for eight oral diseases range from 3 to 7 °C. The excess risks could last for 7 days and were larger in older patients.

Effects of autologous concentrated growth factor on gingival thickness in periodontal accelerated osteogenic orthodontics: a 6-month randomized controlled trial.

BACKGROUND: Earlier studies have not given clear results of concentrated growth factor (CGF) on gingival thickness (GT) in periodontal accelerated osteogenic orthodontics (PAOO). This randomized controlled trial aimed to evaluate the effects of CGF on GT in patients with thin gingival phenotype undergoing PAOO. METHODS: Forty four patients presenting 264 anterior mandibular teeth were recruited and randomly allocated to one of the groups: test-positioning of autologous CGF after PAOO or control-positioning of a collagen membrane after PAOO. GT, gingival height (GH), buccal alveolar bone thickness (BT), and buccal alveolar bone height (BH) were evaluated depending on cross-sectional CBCT images at t0 (before surgery) and t1(6 months after surgery). RESULTS: GT were increased in both groups at t1 compared to t0. Yet, higher values were observed in the test group (from 0.94 ± 0.23 to 1.31 ± 0.33 mm) compared to the control group (from 0.94 ± 0.19 to 1.02 ± 0.16 mm) (p < 0.05). Moreover, in the intergroup comparison, GT at t1 in the test group was significantly higher compared to the control group (p < 0.01). Furthermore, the GT of central incisors, lateral incisors and canine teeth all showed significantly changes compared with baseline and the test group showed higher increase (p < 0.01). No statistically significant difference were found in GH, BT, BH and all clinical parameters between two groups at t1 (p > 0.05). CONCLUSIONS: Within the limitation of this study, gingival thickness could be increased by using CGF in PAOO for the patients with thin gingival phenotype. Trial registration The study was registered in Chinese Clinical Trial Registry ( http://www.chictr.org.cn/index.aspx ) under the number ChiCTRINR17013346, Registered 11 November 2017.

Randomized Clinical Trial of the Accuracy of Patient-Specific Implants versus CAD/CAM Splints in Orthognathic Surgery.

BACKGROUND: The maxilla position is essential for the aesthetic and functional outcomes of orthognathic surgery. Previous studies demonstrated the advantages of patient-specific implants in orthognathic surgery. However, more data are needed to confirm the superiority of patient-specific implants over surgical splints created with computer-aided design/computer-aided manufacturing (CAD/CAM). This randomized controlled trial aimed to compare the accuracy of patient-specific implants and CAD/CAM splints for maxilla repositioning in orthognathic surgery. METHODS: Patients (n = 64) who required orthognathic surgery were randomly assigned to use either patient-specific implants (patient-specific implant group) or CAD/CAM surgical splints (splint group) to reposition the maxilla. The outcome evaluation was completed by comparing virtual plans with actual results. The primary outcome was the discrepancies of the centroid position of the maxilla. Other translation and orientation discrepancies of the maxilla were also assessed. RESULTS: The authors analyzed 27 patients in the patient-specific implant group and 31 in the splint group. The maxilla position discrepancy was 1.41 ± 0.58 mm in the patient-specific implant group and 2.20 ± 0.94 mm in the splint group; the between-group difference was significant (p < 0.001). For the patient-specific implant group, the largest translation discrepancy was 1.02 ± 0.66 mm in the anteroposterior direction, and the largest orientation discrepancy was 1.85 ± 1.42 degrees in pitch. For the splint group, the largest translation discrepancy was 1.23 ± 0.93 mm in the mediolateral direction, and the largest orientation discrepancy was 1.72 ± 1.56 degrees in pitch. CONCLUSION: The result showed that using patient-specific implants in orthognathic surgery resulted in a more accurate maxilla position than CAD/CAM surgical splints. CLINICAL QUESTION/LEVEL OF EVIDENCE: Therapeutic, I.

Alveolar Bone Loss, Tooth Loss and Oral Cancer Mortality in Older Patients: A Retrospective Cohort Study.

PURPOSE: There has been growing interest in the association between periodontitis and systemic disease. In recent years, however, inconsistent results have also been found by case-control studies for the role of periodontitis in the development of oral cancer. This study aimed to examine whether periodontitis was an independent risk factor for oral cancer with a ≥75-year age group cohort. MATERIALS AND METHODS: Between January 2010 and December 2014, 1385 patients aged ≥75 years who underwent radiographic examination were included in this retrospective cohort study. We collected demographic information and comorbid health conditions from local health authorities. Participants were followed up until either the occurrence of mortality, or the end of the study on December 31, 2018. Cox proportional hazards regression and competing risk hazard models were used to examine the association between periodontitis and oral cancer mortality. RESULTS: Periodontitis and loss of teeth were significantly associated with oral cancer mortality. Compared to oral cancer mortality in healthy subjects, the HR and 95% CI in patients with mild, moderate, and severe periodontitis were 4.46 (0.94-21.06), 5.16 (1.14-23.39), and 6.65 (1.51-29.36), respectively. The HR (95% CI) was 1.05 (1.01-1.09) for tooth loss after controlling for potential confounding factors. All the increases in risk persisted in patients aged ≥80 years. CONCLUSION: The present study provides substantial evidence that poor periodontal health is associated with oral cancer mortality. It is necessary to underline the importance of considering periodontitis in the prevention of oral cancer, particularly in the older patients.

Association Between Fine Particulate Matter and Fatal Hemorrhagic Stroke Incidence: A Time Stratified Case-Crossover Study in Shanghai, China.

OBJECTIVES: Evidence of the association between fine particulate (PM2.5, particles ≤2.5 µm in aerodynamic diameter) air pollution and fatal hemorrhagic stroke incidence is limited. This study aims to document the relationship between PM2.5 exposure and fatal hemorrhagic stroke incidence. METHODS: The time-stratified case-crossover approach was applied for the analysis. RESULTS: The mean concentration of PM2.5 is 75.33 µg/m. Fatal hemorrhagic stroke incidence was significantly associated with PM2.5 exposure. Exposure to PM2.5 led to a 5% (2%-9%) and 5% (1%-10%) increase in fatal hemorrhagic stroke incidence in lag2 and lag03 respectively. An increased risk was observed especially in men and subjects with hypertension. CONCLUSIONS: This study provides evidence for the association between PM2.5 exposure and fatal hemorrhagic stroke incidence. Men and subjects with hypertension have increased risks, overweight may further increase their susceptibility to PM2.5 exposure related hemorrhagic stroke.

Periodontitis increases the risk of respiratory disease mortality in older patients.

Evidence for an association between periodontitis and respiratory disease in the older patients is limited. Additionally, little information exists regarding the role of potential effect modifiers. The aim of this study is to examine whether periodontitis increases the risk of respiratory disease mortality in older patients. Between January 2010 and December 2014, 1385 patients aged 75 years and above who underwent radiographic examination in the largest dental hospital in Shanghai, China were included in this retrospective cohort study. The dental examination was made with the panoramic radiographs. Demographic information and comorbid health conditions were collected from local health authorities. Participant follow up was continued until either the occurrence of mortality, or the end of the study on December 31, 2018. Cox proportional hazards regression and competing risk hazard models were performed to examine the association between periodontitis and respiratory disease mortality. We found that periodontitis was associated with total respiratory disease mortality. Compared with healthy participants, the hazards ratio and 95% confidence interval for total respiratory disease mortality in patients with severe periodontitis was 2.72(1.04,7.11) after adjusting for relevant confounding variables. With increasing severity of periodontitis, risks for chronic obstructive pulmonary disease (COPD) mortality also increased significantly (P = .038). Smokers and participants with body mass index (BMI) < 25 kg/m2 were at increased risk. Loss of teeth was not associated with either total respiratory disease or COPD mortality. Although the present study cannot ascertain causal association, it provides substantial evidence that poor periodontal health is associated with respiratory disease in the older patients, particularly in smokers and patients with BMI < 25 kg/m2.

Association between periodontal disease and tooth loss and mortality in an elderly Chinese population.

BACKGROUND: Poor oral health is a risk indicator of poor quality of life and mortality. However, whether these associations remain potent in elderly subjects after adequately considering the confounding factors is not yet clearly elucidated. The present study aimed to investigate the associations between periodontal disease and tooth loss and total mortality and cardiovascular disease (CVD) outcomes in the elderly > 75 years old. METHODS: A total of 1385 individuals, receiving periodontal treatment in Shanghai, participated in this retrospective study. Data on oral status were obtained from radiographs to calculate the proportion of residual bone. The information about mortality was collected from the Shanghai Municipal Center for Disease Control and Prevention (SCDC). Univariate Cox proportional hazards model, multivariable-adjusted model, and competing risk hazard model were used to analyze the association between periodontal disease or tooth loss and mortality. RESULTS: Those with severe periodontitis were associated with higher risk of total mortality than healthy individuals [hazard ratio (HR) = 1.48, 95% confidence interval (95% CI) 1.11-1.98]. Further, missing teeth increased the risk of total mortality (HR = 1.02, 95% CI 1.01-1.03). However, no significant difference was detected in the association between periodontitis or tooth loss and CVD mortality. In competing risk hazard model, an increased risk was observed for other-cause mortality, not CVD mortality, in those with severe periodontitis and missing teeth. CONCLUSION: Periodontal diseases and tooth loss were the potential predictors of total mortality even after adjustment for confounding factors. However, these were not independent indicators for CVD mortality.

A genetic-phenotypic classification for syndromic micrognathia.

Micrognathia is a common craniofacial deformity which represents hypoplastic development of the mandible, accompanied by retrognathia and consequent airway problems. Usually, micrognathia is accompanied by multiple systematic defects, known as syndromic micrognathia, and is in close association with genetic factors. Now, large quantities of pathogenic genes of syndromic micrognathia have been revealed. However, how these different pathogenic genes could lead to similar phenotypes, and whether there are some common characteristics among these pathogenic genes are still unknown. In this study, we proposed a genetic-phenotypic classification of syndromic micrognathia based on pathogenic genes information obtained from Phenolyzer, DAVID, OMIM, and PubMed database. Pathogenic genes of syndromic micrognathia could be divided into four groups based on gene function, including cellular processes and structures, cell metabolism, cartilage and bone development, and neuromuscular function. In addition, these four groups exhibited various clinical characteristics, and the affected systems, such as central nervous system, skeletal system, cardiovascular system, oral and dental system, respiratory system and muscle, were different in these four groups. This classification could provide meaningful insights into the pathogenesis of syndromic micrognathia, and offer some clues for understanding the molecular mechanism, as well as guiding precise clinical diagnosis and treatment for syndromic micrognathia.

Association between incidence of fatal intracerebral hemorrhagic stroke and fine particulate air pollution.

OBJECTIVE: Few studies investigating associations between fine particulate air pollution and hemorrhagic stroke have considered subtypes. Additionally, less is known about the modification of such association by factors measured at the individual level. We aimed to investigate the risk of fatal intracerebral hemorrhage (ICH) incidence in case of PM2.5 (particles ≤ 2.5 µm in aerodynamic diameter) exposure. METHODS: Data on incidence of fatal ICH from 1 June 2012 to 31 May 2014 were extracted from the acute stroke mortality database in Shanghai Municipal Center for Disease Control and Prevention (SCDC). We used the time-stratified case-crossover approach to assess the association between daily concentrations of PM2.5 and fatal ICH incidence in Shanghai, China. RESULTS: A total of 5286 fatal ICH cases occurred during our study period. The averaged concentration of PM2.5 was 77.45 µg/m3. The incidence of fatal ICH was significantly associated with PM2.5 concentration. Substantial differences were observed among subjects with diabetes compared with those without; following the increase of PM2.5 in lag2, the OR (95% CI) for subjects with diabetes was 1.26 (1.09-1.46) versus 1.05 (0.98-1.12) for those without. We did not find evidence of effect modification by hypertension and cigarette smoking. CONCLUSIONS: Fatal ICH incidence was associated with PM2.5 exposure. Our results also suggested that diabetes may increase the risk for ICH incidence in relation to PM2.5.

Detection of alveolar bone defects with three different voxel sizes of cone-beam computed tomography: an in vitro study.

This study was conducted to assess the accuracy of cone-beam computed tomography (CBCT) of different voxel sizes in the detection of alveolar bone defects, and to select the optimal voxel size for clinical use. 46 in-vitro teeth were placed in bovine ribs in which alveolar bone defects were randomly simulated. In total, 32 alveolar bone defects and 14 teeth without periodontal defects were used. CBCT images were acquired with the use of three different voxel sizes: 0.125-mm, 0.2-mm and 0.4-mm. The scan data were 3D-reconstructed in Mimics software and evaluated by two observers with more than 5 years of experience in CBCT. Receiver operating characteristic (ROC) curves and diagnostic values were obtained. Pairwise comparison of ROC curves was made for evaluation of the diagnostic values of different voxel sizes. Kappa statistics assessed the observer reliability. Results were considered significant at P < 0.05. It showed no statistically significant difference between 0.125-mm group and 0.2-mm group, but 0.4-mm group had lower Az values that differed significantly from 0.125-mm and 0.2-mm groups (P < 0.05). Based on diagnostic value and radiation protection, 0.2-mm voxel size may be a good choice for the detection of bone defects with CBCT.

Course of the mandibular canal in hemifacial microsomia: a retrospective computed tomography study.

OBJECTIVE: The aim of this study was to evaluate the anatomic course of the mandibular canal in patients with hemifacial microsomia (HM). STUDY DESIGN: In this retrospective study, 77 patients were included and stratified according to the Pruzansky-Kaban classification. The mandibular canal and the mandible were reconstructed on the basis of computed tomography data. The entrance, route, and exit of the mandibular canal (representing the entrance, route, and exit of the inferior alveolar nerve [IAN], respectively), and the antilingula were analyzed in different types of mandibular deformities in patients with HM. RESULTS: No significant difference in the course of the mandibular canal was detected between the affected and unaffected sides in patients with type I and type IIa HM. Abnormalities were observed in some patients with type IIb and type III HM. Significant differences were found between patients with type IIb and type III HM in the entrance (P = .015) and route (P = .001) of the canals. The antilingula was identified only in patients with type IIb and type III HM and was more common in patients with type III HM than in those with type IIb HM. CONCLUSIONS: Variation of the anatomic course of mandibular canal exists in patients with Pruzansky-Kaban type IIb and type III HM. Evaluation of the course of the canal in patients with HM is recommended before surgical intervention to avoid IAN damage.

Intensity-modulated nanoplasmonic interferometric sensor for MMP-9 detection.

To elucidate the secretary function of immune cells, we develop a nanoplasmonic circular interferometric biosensor based on intensity interrogation for label-free and dynamic sensing of molecular secretion. Exceptional sensitivity has been demonstrated through coupling free light and surface plasmon polariton (SPPs) waves, which generates a constructive and deconstructive interference pattern with high contrast and narrow linewidth when illuminated by white light. Alternatively, by adopting a narrow-band LED source and a CCD camera in this work, the transmission intensity of multiple sensing units is monitored simultaneously with a simple collinear optical setup. This intensity-modulated sensing platform yields a resolution of 4.1 × 10-5 refractive index unit (RIU) with a high temporal resolution of 1 s and a miniaturized footprint as small as 9.8 × 9.8 µm2 for a single sensing unit. By integrating the signals from multiple sensor units, the resolution of a 12 × 12 sensor array was found to reach 7.3 × 10-6 RIU. We apply this sensor array to detect matrix metalloproteinase 9 (MMP-9) secretion from human monocytic cells, THP-1, at different time points after lipopolysaccharide (LPS) simulation and the results are in good agreement with enzyme-linked immunosorbent assay (ELISA) tests, but without the need for labeling. The spatial, temporal and mass resolutions of the sensor array are found to exceed other label-free technologies. These biomolecular arrays, incorporated in a microfluidic sensor platform, hold great potential for the study the dynamics and interplay of cell secretion signals and achieving a better understanding of single cell functions.