Severe magnitude of dental and skeletal fluorosis and its impact on society and environment in a part of Manbhum-Singhbhum Plateau, India.

BACKGROUND: Numerous approaches have been adopted to evaluate limited freshwater resources and the associated health hazards due to excessive amounts of fluoride in drinking water. The study aims to assess the degree and severity of dental and skeletal fluorosis and examine the broader effects of fluorosis on human health and society in the Manbhum-Singhbhum Plateau region, India. METHODS: The Community Fluorosis Index (CFI) and Dean's Index have been used to measure the magnitude and severity of dental and skeletal fluorosis. Questionnaire surveys, Focus Group Discussions (FGDs), and appropriate statistical methods have been applied to identify the social impacts. Risk-prone zones have been identified through overlay analysis using geoinformatics. RESULTS: About 54.60% of people in 67 villages of this part of the Manbhum-Singhbhum Plateau are affected in varying degrees of fluorosis ranging from very mild to mild, moderate, and severe dental fluorosis. Among these 67 villages, Janra (Manbazar I) and Hijla (Barabazar) have the most severely affected people. School dropout (n = 426), social isolation (n = 149), remarriage (n = 21), and physically disabled (n = 75) have also been reported. The study shows that about 414.29 km2 of the Manbhum-Singhbhum Plateau comes under the high-risk-prone category. CONCLUSIONS: The societal and environmental awareness of the fluorosis-affected individuals is almost absent in this region. Economic hardships, lack of education, inadequate health care facilities, water scarcity, and lack of awareness increase the magnitude of health hazards and societal vulnerability of the people in this region, who are largely dependent on natural resources.

Elasto-inertial particle focusing in sinusoidal microfluidic channels.

Dean flow existing in sinusoidal channels could enhance the throughput and efficiency for elasto-inertial particle focusing. However, the fundamental mechanisms of elasto-inertial focusing in sinusoidal channels are still unclear. This work employs four microfluidic devices with symmetric and asymmetric sinusoidal channels to explore the elasto-inertial focusing mechanisms over a wide range of flow rates. The effects of rheological property, flow rate, sinusoidal channel curvature, particle size, and asymmetric geometry on particle focusing performance are investigated. It is intriguing to find that the Dean flow makes a substantial contribution to the particle elasto-inertial focusing. The results illustrate that a better particle focusing performance and a faster focusing process are obtained in the sinusoidal channel with a small curvature radius due to stronger Dean flow. In addition, the particle focusing performance is also related to particle diameter and rheological properties, the larger particles show a better focusing performance than smaller particles, and the smaller flow rate is required for particles to achieve stable focusing at the outlet in the higher concentration of polyvinylpyrrolidone solutions. Our work offers an increased knowledge of the mechanisms of elasto-inertial focusing in sinusoidal channels. Ultimately, these results provide supportive guidelines into the design and development of sinusoidal elasto-inertial microfluidic devices for high-performance focusing.

Prednisolone Nanoprecipitation with Dean Instability Microfluidics Mixer.

Dean flow and Dean instability play an important role in inertial microfluidics, with a wide application in mixing and sorting. However, most studies are limited to Dean flow in the microscale. This work first reports the application of Dean instability on organic nanoparticles synthesis at De up to 198. The channel geometry (the tortuous channel) is optimized by simulation, in which the mixing efficiency is considered. With the optimized design, prednisolone nanoparticles are synthesized, and the size of the most abundant prednisolone nanoparticles is down to 100 nm with an increase in the Re and De and smallest size down to 46 nm. This work serves as an ice-breaker to the real application of Dean instability by demonstrating its ability in mixing and nanomaterials like nanoparticle synthesis.

The Importance of Dean Flow in Microfluidic Nanoparticle Synthesis: A ZIF-8 Case Study.

The Dean Flow, a physics phenomenon that accounts for the impact of channel curvature on fluid dynamics, has great potential to be used in microfluidic synthesis of nanoparticles. This study explores the impact of the Dean Flow on the synthesis of ZIF-8 particles. Several variables that influence the Dean Equation (the mathematical expression of Dean Flow) are tested to validate the applicability of this expression in microfluidic synthesis, including the flow rate, radius of curvature, channel cross sectional area, and reagent concentration. It is demonstrated that the current standard of reporting, providing only the flow rate and crucially not the radius of curvature, is an incomplete description that will invariably lead to irreproducible syntheses across different laboratories. An alternative standard of reporting is presented and it is demonstrated how the sleek and simple math of the Dean Equation can be used to precisely tune the final dimensions of high quality, monodisperse ZIF-8 nanoparticles between 40 and 700 nm.

Microplastic retention in marine vegetation canopies under breaking irregular waves.

The present study provides indications and underlying drivers of wave-induced transport and retention potential of microplastic particles (MP) in marine vegetation canopies having different densities. The anthropogenic occurrence of MP in coastal waters is well documented in the recent literature. It is acknowledged that coastal vegetation can serve as a sink for MP due to its energy dissipating features, which can mimic a novel ecosystem service. While the transport behavior of MP in vegetation has previously been investigated to some extent for stationary flow conditions, fundamental investigations for unsteady surf zone flow conditions under irregular waves are still lacking. Herein, we demonstrate by means of hydraulic model tests that a vegetation's retention potential of MP in waves increases with the vegetation shoot density, the MP settling velocity and decreasing wave energy. It is found that particles migrating by traction (predominantly in contact with the bed) are trapped in the wake regions around a canopy, whereas suspended particles are able to pass vegetated areas more easily. Very dense canopies can also promote the passage of MP with diameters larger than the plant spacing, as the canopies then show characteristics of a solid sill and avoid particle penetration. The particle migration ability through a marine vegetation canopy is quantified, and the key drivers are described by an empirical expression based on the particle settling velocity, the canopy length and density. The findings of this study may contribute to improved prediction and assessment of MP accumulation hotspots in vegetated coastal areas and, thus, may help in tracing MP sinks. Such knowledge can be considered a prerequisite to develope methods or new technologies to recover plastic pollutants and rehabilitate valuable coastal environments.

The Physics and Manipulation of Dean Vortices in Single- and Two-Phase Flow in Curved Microchannels: A Review.

Microchannels with curved geometries have been employed for many applications in microfluidic devices in the past decades. The Dean vortices generated in such geometries have been manipulated using different methods to enhance the performance of devices in applications such as mixing, droplet sorting, and particle/cell separation. Understanding the effect of the manipulation method on the Dean vortices in different geometries can provide crucial information to be employed in designing high-efficiency microfluidic devices. In this review, the physics of Dean vortices and the affecting parameters are summarized. Various Dean number calculation methods are collected and represented to minimize the misinterpretation of published information due to the lack of a unified defining formula for the Dean dimensionless number. Consequently, all Dean number values reported in the references are recalculated to the most common method to facilitate comprehension of the phenomena. Based on the converted information gathered from previous numerical and experimental studies, it is concluded that the length of the channel and the channel pathline, e.g., spiral, serpentine, or helix, also affect the flow state. This review also provides a detailed summery on the effect of other geometric parameters, such as cross-section shape, aspect ratio, and radius of curvature, on the Dean vortices' number and arrangement. Finally, considering the importance of droplet microfluidics, the effect of curved geometry on the shape, trajectory, and internal flow organization of the droplets passing through a curved channel has been reviewed.

The Complicated Middle of the Academic Deanery.

The complicated and ever-growing roles of assistant and associate deans (A-deans) can often be compared to those of middle managers. With responsibilities that are rapidly expanding and often unclear or overlapping with other personnel, A-deans may face identity crises. Additionally, because they are often not at the full professor level, they may experience difficulty achieving promotion. In this commentary, the authors call for increased awareness of the challenges associated with these roles and suggest opportunities for change. To maximize effectiveness in their roles, the Academy and colleges/schools are encouraged to explore workload/expectations for A-deans and associated reward structures, including promotion and tenure guidelines with explicit recognition for the important role(s) they play. A-deans are also encouraged to advocate for infrastructure and responsibilities that support both their academic institution and their own individual professional goals.

A Cross-Sectional Study to Find the Correlation between the Level of Fluoride in Drinking Water, Dental Fluorosis and Associated Risk Factors- A Original Research.

Background: The present study was conducted to assess the relationship between drinking water fluoride (F) levels, dental fluorosis dental caries, and associated risk factors in the elderly population. Materials and Methods: A cross-sectional analytical study was conducted on 50 patients aged 25-60 years, selected by stratified random sampling from different areas with different levels of naturally occurring F in drinking water. The patients were assessed for dental fluorosis according to WHO basic survey guidelines. The overall oral health status of the patients was assessed by decayed missing filled teeth DMFT index and the bacterial count of saliva was calculated using the Caries Risk Test (CRT). Statistical analysis was done using mean, standard deviation, standard error, Z-test, Mann-Whitney U Test, and Chi-square test. Results: The results of the present study revealed that the prevalence of fluorosis was 24%. The number of patients with dental fluorosis was highest in those who consumed water with high groundwater fluoride levels irrespective of the source of drinking water. Caries prevalence in the study population was about 5.56 ± 1.95. Conclusion: There was a moderate prevalence of fluorosis in patients, and caries prevalence is high in areas below optimal F areas. Caries prevalence and mean DMFT scores were least common in patients with optimal fluoride levels in drinking water and highest in those with below optimal fluoride in drinking water.

Evolution of focused streams for viscoelastic flow in spiral microchannels.

Particle migration dynamics in viscoelastic fluids in spiral channels have attracted interest in recent years due to potential applications in the 3D focusing and label-free sorting of particles and cells. Despite a number of recent studies, the underlying mechanism of Dean-coupled elasto-inertial migration in spiral microchannels is not fully understood. In this work, for the first time, we experimentally demonstrate the evolution of particle focusing behavior along a channel downstream length at a high blockage ratio. We found that flow rate, device curvature, and medium viscosity play important roles in particle lateral migration. Our results illustrate the full focusing pattern along the downstream channel length, with side-view imaging yielding observations on the vertical migration of focused streams. Ultimately, we anticipate that these results will offer a useful guide for elasto-inertial microfluidics device design to improve the efficiency of 3D focusing in cell sorting and cytometry applications.

Mixing Performance of a Passive Micromixer Based on Multiple Baffles and Submergence Scheme.

A novel passive micromixer based on multiple baffles and a submergence scheme was designed, and its mixing performance was simulated over a wide range of Reynolds numbers ranging from 0.1 to 80. The degree of mixing (DOM) at the outlet and the pressure drop between the inlets and outlet were used to assess the mixing performance of the present micromixer. The mixing performance of the present micromixer showed a significant enhancement over a wide range of Reynolds numbers (0.1 ≤ Re ≤ 80). The DOM was further enhanced by using a specific submergence scheme. At low Reynolds numbers (Re < 5), submergence scheme Sub24 produced the highest DOM, approximately 0.57, which was 1.38 times higher than the case with no submergence. This enhancement was due to the fluid flowing from or toward the submerged space, creating strong upward or downward flow at the cross-section. At high Reynolds numbers (Re > 10), the DOM of Sub1234 became the highest, reaching approximately 0.93 for Re = 20, which was 2.75 times higher than the case with no submergence. This enhancement was caused by a large vortex formed across the whole cross-section, causing vigorous mixing between the two fluids. The large vortex dragged the interface between the two fluids along the vortex perimeter, elongating the interface. The amount of submergence was optimized in terms of DOM, and it was independent of the number of mixing units. The optimum submergence values were 90 µm for Sub24 and Re = 1, 100 µm for Sub234 and Re = 5, and 70 µm for Sub1234 and Re = 20.

Analysis of multiple pathways and levels of fluoride intake in fluorosis areas of Southwest China.

In the coal-burning fluorosis areas of China, over 10 million people suffer from dental fluorosis caused by multiple pathways of fluoride intake. However, the link between dental fluorosis prevalence, the geochemical distribution of fluoride, and contributions of different exposure pathways remain unclear. Here, we aimed to quantify the various fluoride exposure pathways and establish the association between dental fluorosis and fluoride intake in Southwest China. Epidemiological data on the peak time of fluorosis prevalence were combined with geochemical analyses of the fluoride content in coal and clay over a large scale, the amounts and ratios of fluoride intake through different exposure pathways were calculated, and the association between the total daily fluoride intake (TDFI) and dental fluorosis severity was analyzed. The prevalence of dental fluorosis was not significantly correlated with the fluoride geo-background of coal and clay on a large scale (P > 0.05). The co-combustion of coal and clay contained in hand-made briquettes is the main pathway of fluoride contamination, which occurs through the inhalation of polluted air and consumption of contaminated roasted products. Furthermore, the TDFI per person ranged from 2.78 to 17.32 mg, and it was significantly positively correlated with the prevalence of dental fluorosis (P < 0.05). The TDFI from breathing and eating was 1.1-3.2 mg and 1.1-15.1 mg, which accounted for 9%-54% and 40%-90% of the total TDFI, respectively. The combination of living habits and soil geochemical fluoride anomalies resulted in the higher prevalence of fluorosis in rural areas of Southwest China.

Fuzzy K-Nearest Neighbor Based Dental Fluorosis Classification Using Multi-Prototype Unsupervised Possibilistic Fuzzy Clustering via Cuckoo Search Algorithm.

Dental fluorosis in children is a prevalent disease in many regions of the world. One of its root causes is excessive exposure to high concentrations of fluoride in contaminated drinking water during tooth formation. Typically, the disease causes undesirable chalky white or even dark brown stains on the tooth enamel. To help dentists screen the severity of fluorosis, this paper proposes an automatic image-based dental fluorosis segmentation and classification system. Six features from red, green, and blue (RGB) and hue, saturation, and intensity (HIS) color spaces are clustered using unsupervised possibilistic fuzzy clustering (UPFC) into five categories: white, yellow, opaque, brown, and background. The fuzzy k-nearest neighbor method is used for feature classification, and the number of clusters is optimized using the cuckoo search algorithm. The resulting multi-prototypes are further utilized to create a binary mask of teeth and used to segment the tooth region into three groups: white-yellow, opaque, and brown pixels. Finally, a fluorosis classification rule is created based on the proportions of opaque and brown pixels to classify fluorosis into four classes: Normal, Stage 1, Stage 2, and Stage 3. The experimental results on 128 blind test images showed that the average pixel accuracy of the segmented binary tooth mask was 92.24% over the four fluorosis classes, and the average pixel accuracy of segmented teeth into white-yellow, opaque, and brown pixels was 79.46%. The proposed method correctly classified four classes of fluorosis in 86 images from a total of 128 blind test images. When compared with a previous work, this result also indicates 10 out of 15 correct classifications on the blind test images, which is equivalent to a 13.33% improvement over the previous work.

Dean-Flow Affected Lateral Focusing and Separation of Particles and Cells in Periodically Inhomogeneous Microfluidic Channels.

The purpose of the recent work is to give a better explanation of how Dean vortices affect lateral focusing, and to understand how cell morphology can alter the focusing position compared to spherical particles. The position and extent of the focused region were investigated using polystyrene fluorescent beads with different bead diameters (Ø = 0.5, 1.1, 1.97, 2.9, 4.8, 5.4, 6.08, 10.2, 15.8, 16.5 µm) at different flow rates (0.5, 1, 2 µL/s). Size-dependent focusing generated a precise map of the equilibrium positions of the spherical beads at the end of the periodically altering channels, which gave a good benchmark for focusing multi-dimensional particles and cells. The biological samples used for experiments were rod-shaped Escherichia coli (E. coli), discoid biconcave-shaped red blood cells (RBC), round or ovoid-shaped yeast, Saccharomyces cerevisiae, and soft-irregular-shaped HeLa cancer-cell-line cells to understand how the shape of the cells affects the focusing position at the end of the channel.

Medical school dean's scientific production of the main universities by continent / Produção científica dos reitores de medicina das principais universidades por continente

Introduction: promoting scientifi c research is one of the main functions of universities. Medical schools should not be an exception; deans should also have appropriate research experience that allows them to have a different perspective on the importance of research in undergraduate medicine. Aim: to determine the medical school dean's scientific production of the main universities by continent. Methods: an observational, analytical, and transversal study. We identify the medical school dean's scientific production of the 20 universities with the best position from South America, Central America, North America, Europe, Asia, Africa, and Oceania, according to the Ranking Webometrics 2022, in the Scopus database. Results: 140 directors or deans of medicine were evaluated, of which 136 (97.1%) had published an article at least once in their life, 128 (91.4%) in the last fi ve years, 103 (73.6%) in the previous year, and 93 (66.4%) in the current year. The total number of published articles was 24.5 (Me=98), receiving a total of 1,251,766 citations (range 0 to 101,868), an Hindex 24 (range 0 to 140), and in collaboration with 154,711 coauthors. Conclusions: the medical school dean's scientific production from the main universities by continent was high, with notable differences between those who came from universities in Asia, North America, and Europe compared to Oceania, Africa, South America, and Central America

Introdução: promover a pesquisa científica é uma das principais funções das universidades. As escolas médicas não devem ser uma exceção. Os reitores também devem ter uma experiência de pesquisa adequada que lhes permita ter uma perspectiva diferente sobre a importância da pesquisa na graduação em medicina. Objetivo: determinar a produção científica dos reitores de medicina das principais universidades por continente. Métodos: estudo observacional, analítico e transversal. Identificamos a produção científica dos pró-reitores de medicina das 20 universidades com melhor posição da América do Sul, América Central, América do Norte, Europa, Ásia, África e Oceania, segundo o Ranking Webometrics 2022, na base Scopus. Resultados: foram avaliados 140 diretores ou reitores de medicina, dos quais 136 (97.1%) publicaram artigo pelo menos uma vez na vida, 128 (91.4%) nos últimos cinco anos, 103 (73.5%) no ano anterior, e 93 (66.4%) no ano corrente. O número total de artigos publicados foi de 24.5 (Me=98), recebendo um total de 1,251,766 citações (intervalo de 0 a 101.868), índice H = 24 (intervalo de 0 a 140) e em colaboração com 154,711 coautores. Conclusões: a produção científica dos reitores de medicina das principais universidades por continente foi alta, com diferenças notáveis entre aqueles que vieram de universidades da Ásia, América do Norte e Europa em comparação com Oceania, África, América do Sul e América Central

Serpentine Micromixers Using Extensional Mixing Elements.

Computational fluid dynamics modeling was used to characterize the effect of the integration of constrictions defined by the vertices of hyperbolas on the flow structure in microfluidic serpentine channels. In the new topology, the Dean flows characteristic of the pressure-driven fluid motion along curved channels are combined with elongational flows and asymmetric longitudinal eddies that develop in the constriction region. The resulting complex flow structure is characterized by folding and stretching of the fluid volumes, which can promote enhanced mixing. Optimization of the geometrical parameters defining the constriction region allows for the development of an efficient micromixer topology that shows robust enhanced performance across a broad range of Reynolds numbers from Re = 1 to 100.

Influence of right coronary artery motion, flow pulsatility and non-Newtonian rheology on wall shear stress metrics.

The patchy distribution of atherosclerosis within the arterial system is consistent with a controlling influence of hemodynamic wall shear stress (WSS). Patterns of low, oscillatory and transverse WSS have been invoked to explain the distribution of disease in the aorta. Disease of coronary arteries has greater clinical importance but blood flow in these vessels may be complicated by their movement during the cardiac cycle. Previous studies have shown that time average WSS is little affected by the dynamic geometry, and that oscillatory shear is influenced more. Here we additionally investigate effects on transverse WSS. We also investigate the influence of non-Newtonian blood rheology as it can influence vortical structure, on which transverse WSS depends; Carreau-Yasuda models were used. WSS metrics were derived from numerical simulations of blood flow in a model of a moving right coronary artery which, together with a subject-specific inflow waveform, was obtained by MR imaging of a healthy human subject in a previous study. The results confirmed that time average WSS was little affected by dynamic motion and that oscillatory WSS was more affected. They additionally showed that transverse WSS and its non-dimensional analogue, the Cross Flow Index, were affected still further. This appeared to reflect time-varying vortical structures caused by the changes in curvature. The influence of non-Newtonian rheology was significant with some physiologically realistic parameter values, and hence may be important in certain subjects. Dynamic geometry and non-Newtonian rheology should be incorporated into models designed to produce maps of transverse WSS in coronary arteries.

Prevalence of dental fluorosis and dental caries in fluoride endemic areas of Rohtak district, Haryana.

Objectives: This study investigates the estimation of the fluoride concentration in drinking water in Rohtak district, Haryana, and quantifies its effect on the prevalence of dental fluorosis and dental caries. Materials and Methods: A cross-sectional survey was conducted among 1262 school children in endemic fluoride areas of Haryana. Using simple random sampling, thirty villages from five blocks of Rohtak districts were selected, and children 6-12 years of age were examined. A questionnaire survey form was filled out to record the demographic details of the samples. Dental caries was recorded according to DMFT (D = Decayed, M = Missing due to caries only, F = Filled, T = Teeth)/deft index (d = decayed, e = extracted due to caries, f = filled, t = teeth). Assessment of Dental Fluorosis was done according to Dean's Fluorosis index, modified in 1942. The data were analyzed using SPSS version 19, and nonparametric tests were used to assess the significance. Results: The study participants included 615 males and 647 females among which Mean DMFT in the area of study ranged from 0.32 to 1.90. Mean deft in the area of study ranged from 0.34 to 1.91. The fluoride concentrations in groundwater are in the range of 0.532-8.802. Out of 1262 children examined, 655 (51.90%) children were having dental fluorosis. 607 (48.10%) of the subjects were free from fluorosis. 16.09%, 13.39%, 9.11%, and 8.16% and 5.15% were having questionable, very mild, mild, moderate, and severe form of fluorosis, respectively. Conclusion: It can be concluded that in Rohtak district, the fluoride levels in drinking water and the prevalence of dental fluorosis are high, so requiring an urgent need to improve the quality of water and institute de-fluoridation of drinking water in affected areas to lower the burden of dental fluorosis in the community.

Assessing Fluorosis Incidence in Areas with Low Fluoride Content in the Drinking Water, Fluorotic Enamel Architecture, and Composition Alterations.

There is currently no consensus among researchers on the optimal level of fluoride for human growth and health. As drinking water is not the sole source of fluoride for humans, and fluoride can be found in many food sources, this work aimed to determine the incidence and severity of dental fluorosis in Poland, in areas where a low fluoride content characterizes the drinking water, and to assess the impact of fluoride on the enamel composition and microstructure. The dental examination involved 696 patients (aged 15−25 years) who had since birth lived in areas where the fluoride concentration in drinking water did not exceed 0.25 mg/L. The severity of the condition was evaluated using the Dean's Index. Both healthy teeth and teeth with varying degrees of fluorosis underwent laboratory tests designed to assess the total protein and fluoride content of the enamel. Protein amount was assessed spectrophotometrically while the level of fluoride ions was measured by DX-120 ion chromatography. The clinical study revealed 89 cases (12.8%) of dental fluorosis of varying severity. The enamel of teeth with mild and moderate fluorosis contained a significantly higher protein (p-value < 0.001 and 0.002, respectively) and fluoride level (p < 0.001) than those with no clinical signs of fluorosis. SEM images showed irregularities in the structure of the fluorotic enamel. An excessive fluoride level during amelogenesis leads to adverse changes in the chemical composition of tooth enamel and its structure. Moreover, dental fluorosis present in areas where drinking water is low in fluorides indicates a need to monitor the supply of fluoride from other possible sources, regardless of its content in the water.

Simple and rapid separation of Haematococcus pluvialis and ciliate based on the dean-coupled inertial microfluidics.

Astaxanthin with high antioxidant activity is of great practical value and Haematococcus pluvialis is recognized as the best natural astaxanthin producer. The yield of Haematococcus pluvialis was often affected by the ciliate during its production, however, the use of biochemical pesticides might have a great impact on Haematococcus pluvialis. Therefore, a simple microfluidic chip with the spiral microchannel was developed for continuous-flow physical separation of ∼10 µm ciliate from ∼30 µm Haematococcus pluvialis since their different sizes resulted in different equilibrium positions in the channel due to the Dean-coupled inertial migration. First, a spiral microchannel with a width of 700 µm and a height of 130 µm in the microfluidic chip was developed using three-dimensional printing and verified to completely separate polystyrene particles of 10 µm from those of 30 µm. Then, this microfluidic chip was used to separate the actual sample, and experimental results showed that ∼80% of ciliate was continuously separated from Haematococcus pluvialis at a flow rate of 2.8 ml/min. More importantly, no additional biochemical reagents were used and the activity of Haematococcus pluvialis was not affected. This microfluidic chip featured with simple design, automatic operation, and small size is promising for purification and breeding of Haematococcus pluvialis.