Evaluation of the effectiveness of the platelet-rich plasma compared to the injectable platelet-rich fibrin on the rate of maxillary canine retraction: a three-arm randomized controlled trial.

BACKGROUND: Blood-derived materials have been used recently to accelerate orthodontic tooth movement, but there are conflicting reports on their effectiveness. OBJECTIVE: To evaluate the potential effect of local injection of platelet-rich plasma (PRP) and injectable platelet-rich fibrin (i-PRF) on the rate of orthodontic tooth movement. TRIAL DESIGN: A single-center, three-arm, parallel-group randomized controlled trial. MATERIALS AND METHODS: The sample consisted of 60 patients aged between 18 and 25 years (mean age: 21.1 ±â€…2.2 years) with Class II division 1 malocclusion requiring anterior retraction. Using a computer-generated list of random numbers, patients were assigned to three groups of canine retraction: (i) assisted with PRP injection (PRP group), (ii) assisted with i-PRF group, and (iii) conventional treatment with no injections (Cont. group). In the interventional groups, injections were done immediately and at 8 weeks after the onset of canine. Transpalatal arches (TPAs) were used to reinforce anchorage. The upper canines were distalized on 0.019 × 0.025-inch stainless archwires using coil springs with a force of 150 g. The primary outcome was the amount of canine retraction, whereas the secondary outcomes were canine rotation and anchoring loss. Assessment was done at five-time points: the beginning of tooth movement (T0) and at 4, 8, 12, and 16 weeks following T0 on three-dimensional superimposed digital models. RESULTS: Sixty patients were randomized and included in this study (20 patients in each group), there were no dropouts. The rate of canine retraction was faster in the experimental groups. The PRP group showed a significantly slower movement in the second and fourth months than the i-PRF group while in the first and third months, there were nonsignificant differences between the two experimental groups. LIMITATIONS: Blinding was not possible during the clinical stage of this trial. CONCLUSIONS: PRP and i-PRF were found to be effective in accelerating orthodontic tooth movement during canine retraction. However, the effect of i-PRF was longer than that of PRP. TRIAL REGISTRATION: ClinicalTrials.gov (ID: NCT05335824).

Evaluation of Patient-Centered Outcomes Associated With the Acceleration of en-Masse Retraction of Upper Anterior Teeth Assisted by Flapless Corticotomy Compared to Traditional Corticotomy: A Two-Arm Randomized Controlled Trial.

OBJECTIVE: This study aimed to assess the levels of pain, discomfort, and functional impairment associated with the en-masse retraction of the upper anterior teeth when treating Class II division 1 malocclusion patients using traditional corticotomy or flapless corticotomy. In addition, an assessment of patients' satisfaction with the selected surgical intervention was undertaken at one-month post-operatively. MATERIALS AND METHODS: The study sample comprised 40 patients with Class II division 1 malocclusion, randomly assigned to either the traditional corticotomy group (n=20) or the flapless corticotomy group (n=20). Patients underwent extraction of the maxillary first premolars, and orthodontic mini-screws were placed between the maxillary second premolars and the first molars for skeletal anchorage. An en-masse retraction was accomplished in both groups. Patients were asked to fill in a questionnaire at 24 hours (T1), four days (T2), seven days (T3), 14 days (T4), and 28 days (T5) after the surgical intervention using standardized questionnaires. Most questions were answered on a visual analog scale where zero scores meant the absence of pain, discomfort, or functional impairment, and 100 scores meant the worst feelings of these traits. RESULTS: All patients in both groups entered data analysis with no dropouts. All measured levels were significantly greater in the traditional corticotomy group during the first two weeks following the corticotomy intervention in terms of pain perception (P˂0.001), discomfort (P=0.004), and difficulty in chewing (P=0.015). Additionally, during the first week following corticotomy, levels of perception of discomfort (P˂0.001), difficulty in swallowing (P=0.001), and limitation of jaw movement (P˂0.001) were significantly greater in the traditional corticotomy group. Patient satisfaction, the recommendation to a friend, and acceptance of flapless corticotomy were significantly greater than traditional corticotomy (P=0.002, P=0.001, respectively). 78% of patients in the traditional corticotomy group considered it more discomfort than a tooth extraction, while 50% of patients in the flapless corticotomy group considered tooth extraction more discomfort, with a significant difference between the two groups (P=0.001). CONCLUSIONS: The levels of negative patients' reported outcomes were significantly smaller with flapless corticotomy than with traditional corticotomy. Traditional corticotomy was associated with mild to moderate levels of pain, swallowing difficulty, moderate levels of discomfort, chewing difficulty, and jaw movement limitation after 24 hours of the surgical procedure. In contrast, flapless corticotomy was less problematic and associated with mild pain, swelling, chewing difficulty, jaw movement limitation, and swallowing difficulty at the same assessment time. Patient satisfaction, acceptance, and recommendation to a friend were greater for flapless corticotomy than traditional intervention.

Effectiveness of Two Intensity Levels of Diode Laser in Debonding Metallic Brackets Regarding Enamel Surface Integrity and Pulpal Temperature: An Ex-Vivo Study.

INTRODUCTION: The traditional methods of deboning metal brackets exert excessive force, resulting in enamel scratches, fractures, and patient discomfort. The objective of this study was to evaluate the effectiveness of using two intensity levels of a diode laser for debonding metallic orthodontic brackets as an alternative to the conventional debonding method. MATERIALS AND METHODS: Sixty intact, extracted human premolar teeth were used in this study, and metal orthodontic brackets were bonded to the buccal surface of these teeth. The teeth were divided into three groups for the experiment: (1) the control group, where conventional bracket debonding was performed using a debonding plier, (2) the first experimental group, where a diode laser (2.5W, 980nm) was utilized for laser debonding, and (3) the second experimental group, where a diode laser (5W, 980nm) was used for laser debonding. The laser was applied using a sweeping movement for 5 seconds. After debonding, the adhesive remnant index (ARI), the lengths, and the frequency of enamel cracks were compared among the groups. Additionally, an increase in intra-pulpal temperature was measured. RESULTS: In all groups, there were no instances of enamel fractures. Laser debonding resulted in a significant reduction in both the frequency and length of newly formed enamel cracks compared to the conventional debonding method. The laser debonding group exhibited increases in intra-pulpal temperature of 2.37°C and 3.60°C in the second and third groups, respectively. These temperature increases were significantly lower than the threshold of 5.5°C. There were no significant differences observed in the ARI scores among the groups. CONCLUSION: With all debonding methods, an increase in the length and frequency of enamel cracks should be anticipated. However, laser-assisted debonding of metal brackets offers the advantage of reducing the risk of enamel damage while avoiding thermal damage to the pulp.

Domain Adaptive Object Detection via Balancing Between Self-Training and Adversarial Learning.

Deep learning based object detectors struggle generalizing to a new target domain bearing significant variations in object and background. Most current methods align domains by using image or instance-level adversarial feature alignment. This often suffers due to unwanted background and lacks class-specific alignment. A straightforward approach to promote class-level alignment is to use high confidence predictions on unlabeled domain as pseudo-labels. These predictions are often noisy since model is poorly calibrated under domain shift. In this paper, we propose to leverage model's predictive uncertainty to strike the right balance between adversarial feature alignment and class-level alignment. We develop a technique to quantify predictive uncertainty on class assignments and bounding-box predictions. Model predictions with low uncertainty are used to generate pseudo-labels for self-training, whereas the ones with higher uncertainty are used to generate tiles for adversarial feature alignment. This synergy between tiling around uncertain object regions and generating pseudo-labels from highly certain object regions allows capturing both image and instance-level context during the model adaptation. We report thorough ablation study to reveal the impact of different components in our approach. Results on five diverse and challenging adaptation scenarios show that our approach outperforms existing state-of-the-art methods with noticeable margins.

Promising Application of Automated Liquid Culture System and Arbuscular Mycorrhizal Fungi for Large-Scale Micropropagation of Red Dragon Fruit.

Red dragon fruit (Hylocereus polyrhizus) is an economic and promising fruit crop in arid and semi-arid regions with water shortage. An automated liquid culture system using bioreactors is a potential tool for micropropagation and large-scale production. In this study, axillary cladode multiplication of H. polyrhizus was assessed using cladode tips and cladode segments in gelled culture versus continuous immersion air-lift bioreactors (with or without a net). Axillary multiplication using cladode segments (6.4 cladodes per explant) was more effective than cladode tip explants (4.5 cladodes per explant) in gelled culture. Compared with gelled culture, continuous immersion bioreactors provided high axillary cladode multiplication (45.9 cladodes per explant) with a higher biomass and length of axillary cladodes. Inoculation of H. polyrhizus micropropagated plantlets with arbuscular mycorrhizal fungi (Gigaspora margarita and Gigaspora albida) significantly increased the vegetative growth during acclimatization. These findings will improve the large-scale propagation of dragon fruit.

Assessment of dietary magnesium intake in the Eastern Province of Saudi Arabia.

Magnesium is an essential element and the most abundant intracellular cation after potassium. This cross-sectional study assessed the average dietary magnesium intake among residents of the Eastern Province of Saudi Arabia. Data was collected using a self-reported validated electronic questionnaire between April 2022 and July 2023. The first part of the survey included demographic data, and the second section comprised 33 items, including a semi-quantitative tool specifically designed to evaluate magnesium intake over the last three months. We included 1065 participants, out of whom 61.1% were women. The predominant age group was 19 - 26 years (56.9%), and most participants (83.3%) reported no comorbidities. The majority (48.5%) had normal weight, 246 (23%) were overweight, and 193 (18.1%) were obese. Most participants had low dietary magnesium intake, ranging from one to five times monthly. There was a positive correlation between age and dietary magnesium consumption. The study highlights a concerning trend of low magnesium intake, representing a risk for various chronic diseases. This trend could be linked to increased consumption of typical diets low in magnesium, such as those high in refined sugars, flour, and processed foods, prevalent among the younger Saudi population.

A unique physics-inspired deep-learning-based platform introducing a generalized tool for rapid optical-response prediction and parametric-optimization for all-dielectric metasurfaces.

Metasurfaces are composed of a two-dimensional array of carefully engineered subwavelength structures. They provide a novel compact alternative to conventional voluminous optical components. However, their design involves a time-consuming hit and trial procedure, requiring many iterative electromagnetic simulations through expensive commercial solvers. To overcome this non-practical design strategy, recently, various deep-learning-based fast and low computational cost networks have been proposed to design and optimize individual meta-atoms and complete metasurfaces. Most of them focus on optimizing the amplitude response of nanostructures, whereas mapping the phase response is a much more challenging problem that needs to be addressed. Since the metaatom's optical response is entirely reliant on and vulnerable to its geometrical structure, underlying material, and operating wavelength, changing any of these parameters changes the entire physics of the problem in hand. Here, we propose novel deep-learning-based generalized forward and inverse design approaches to optimize all-dielectric transmissive metasurfaces. The proposed forward predicting neural networks take all the geometrical parameters and the physical properties of the bar-shaped dielectric nano-resonators as the input and predict the cross-polarized transmission amplitude and modulated phase at eight distinct rotation angles of the nano-bar. These networks are generalized to predict the electromagnetic (EM) response of different dielectric materials at different operating wavelengths. An inverse design neural network is also proposed that takes the target transmission amplitude and phase at eight discrete orientation angles of the nano-bar as the primary input. The underlying physics of the problem is also incorporated by feeding the intrinsic material properties and the operating wavelength of the nano-bar as a second input to the inverse neural network. It predicts the optimum set of geometrical parameters to achieve maximum cross-polarized transmission and complete Pancharatnam-Berry (PB) phase coverage from 0 to 2π. The average test data mean square error (MSE) achieved for the forward predicting neural network is 1.8 × 10-3 and that of the inverse design neural network is 2.8 × 10-1. The average MSEs for different material's test samples are demonstrated to validate the generalizability of the proposed models in terms of seen and unseen materials. A comparative analysis of the proposed approach with conventional EM software optimization tools is performed to prove that the proposed inverse design works much faster than the conventional methods, also it can handle a comparatively larger range of parameters and predicts the results in a single run with high accuracy.

Perspectives on Telemedicine during the Era of COVID-19; What Can Saudi Arabia Do?

The coronavirus disease 2019 (COVID-19) pandemic has represented a challenge to medical practice in Saudi Arabia and worldwide. In contrary to the increasing numbers of COVID-19 patients, there was a limitation in the capacity of medical practices and access to healthcare. A growing body of evidence from healthcare settings in Saudi Arabia and worldwide has suggested a possible role for telemedicine in responding to this evolving need. Telemedicine can be used for triage, direct care, follow-up, and consultation. It could be delivered through synchronous, asynchronous, and mixed approaches. While telemedicine has several advantages, such as accessibility and cost-effectiveness, its diagnostic reliability should be further investigated. The Saudi Vision (2030) has drawn up a roadmap to invest in digital healthcare during the coming decade; however, some barriers related to using telemedicine in Saudi healthcare settings, including cultural issues and technical difficulties, should be openly discussed. In addition, before putting telemedicine in practice on a wide scale in Saudi Arabia, more efforts should be carried out to issue updated legislation and regulations, discuss and respond to ethical concerns, and ensure data security.

Prevalence of and Risk Factors for Nonprescription Antibiotic Use among Individuals Presenting to One Hospital in Saudi Arabia after the 2018 Executive Regulations of Health Practice Law: A Cross-Sectional Study.

Antibiotic resistance is a worldwide public health emergency. Nonprescription antibiotic use is a chief cause of antibiotic resistance. The Saudi Government, as a consequence, imposed in 2018 executive regulations to prevent the distribution of antibiotics without a prescription. Herein, we aimed to investigate the prevalence of and risk factors for nonprescription antibiotic use among individuals presenting to one hospital in Saudi Arabia after enacting these regulations. This cross-sectional study was conducted on people, aged ≥18 years, who presented to the primary healthcare clinics of King Khalid University Hospital in Riyadh during the period between 1/1/2019 and 28/2/2019. Participants were asked to fill out a self-administrated questionnaire assessing their nonprescription antibiotic use during the past year in addition to sociodemographic information. Then, logistic regression analyses were performed to calculate the odds ratios (ORs) and corresponding 95% confidence intervals (CIs) for age, sex, education, and nationality of any nonprescription antibiotic use compared with no use within the past year. Out of 463 participants, 62.9% were females, 67.4% were <40 years, and 93.7% were Saudi citizens. Overall, 30.5% of participants reported nonprescription antibiotic use during the past year (19.7% one to two times and 10.8% more than two times). Male and non-Saudi participants were more likely to report any nonprescription antibiotic use, with HRs (95% CIs) of 1.99 (1.30, 3.04) and 3.81 (1.73, 8.35), respectively. The main reasons behind nonprescription antibiotic use were having previous experience with a health condition (69.2%), inaccessibility of healthcare (26.6%), and recommendation from a relative or a friend (16.1%). A major limitation of this study was that it included individuals attending one hospital. Individuals who seek medical consultation could be dissimilar to those who do not see doctors regarding nonprescription antibiotic use.

Vicarious Traumatization Questionnaire: Psychometric Properties Using Rasch Model and Structural Equation Modeling.

Frontline healthcare providers are exposed to indirect trauma through dealing with traumatized patients. This puts them at risk of vicarious traumatization. In response to the COVID-19 pandemic, this study seeks to establish the psychometric properties of the Malay version of the Vicarious Traumatization Questionnaire among healthcare providers. A cross-sectional study was conducted. The translated Malay version of the Vicarious Traumatization Questionnaire was completed by 352 healthcare providers in Kelantan, Malaysia. The data was entered using IBM SPSS Statistics version 26.0 (SPSS Inc., Chicago, IL, USA, 2019), and descriptive analysis was performed. The psychometric properties of the scale were assessed in two phases. The Rasch model to assess the validity and reliability was performed using Winsteps version 3.72.3. The confirmatory factor analysis using the structural equation modeling was performed using AMOS version 23.0. The Rasch analysis showed that the 38 items, in two constructs, had high item reliability and item separation at 0.97 and item separation at 5.36, respectively, while good person reliability and person separation were at 0.95 and 4.58, respectively. The correlations of all persons and items are greater than 0.20. There are no misfitting or overfitting items in the outfit MNSQ. There are four items that are challenging in answering the scale. The final model of the confirmatory factor analysis shows two constructs with 38 items demonstrating acceptable factor loadings, domain to domain correlation, and best fit (Chi-squared/degree of freedom = 4.73; Tucker-Lewis index = 0.94; comparative fit index = 0.94; and root mean square error of approximation = 0.10). Composite reliability and average variance extracted of the domains were higher than 0.7 and 0.5, respectively. The Vicarious Traumatization Questionnaire tested among healthcare providers has been shown to valid and reliable to assess vicarious traumatization.

Mammography uptake among the female staff of King Saud University.

BACKGROUND: Breast cancer is having a major impact on women's health worldwide. Early detection is the best defense against the associated morbidity and mortality of the disease. OBJECTIVES: To assess the level of mammography uptake among working Saudi women and identify the obstacles and barriers that negatively affect it. In addition, to identify the most effective sources of breast-cancer-related information and early detection screening. METHOD: We conducted a cross-sectional study of women employees of King Saud University aged 40 years and above on March-May 2015 using a self-report questionnaire. RESULTS: A total of 229 participants were recruited from the female staff of King Saud University. Of the participants, 34% were aged 41 years or above, approximately 66% were married, 53.3% had a bachelor's degree, and 61.1% worked as administrators; further, 64.6% had a history of breastfeeding. The rate of mammography uptake was 51.5%. Univariate logistic regression indicated that age, education, and being single predict the rate of mammography uptake. However, multivariate logistic regression indicated that earlier age significantly predicts a higher risk of a low rate of mammography uptake. The main obstacle negatively affecting mammography uptake was ineligible criteria (21.8%). The main sources of information regarding breast cancer were awareness campaigns and television and radio (45.4% and 43.7%, respectively). CONCLUSION: The participants' rate of mammography uptake, awareness of mammograms, the risk factors, and signs of breast cancer were low. To improve breast-cancer mortality rates in Saudi Arabia, earlier detection of breast cancer through increasing awareness of mammograms is of paramount importance.

Concentrations of TENORMs in the petroleum industry and their environmental and health effects.

Crude oil and its products and wastes are among the significant sources of naturally occurring radioactive materials (NORMs). These materials may be enhanced to high levels due to technological and human activities, which are called technologically enhanced naturally occurring radioactive materials (TENORMs). Thus, the average radioactivity of these radionuclides sometimes exceeds the exemption level of 10 000 Bq kg-1, which is recommended by the IAEA's safety standards. TENORMs in the oil and gas industry may generate greater radioactivity levels, which eventually represents potential environmental and health risks. This will require continuous attention by monitoring and surveillance during routine processes in the petroleum industry. In this paper, a comprehensive review of the published literature is conducted to evaluate the TENORM concentrations in the oil and gas industry. Moreover, their environmental and health hazards in different regions of the world are discussed.

Reactivity ratios for organotin copolymer systems.

Di(tri-n-butyltin) itaconate (DTBTI) and monoethyl tributyltin fumarate (METBTF) were synthesized as organotin monomers. The organotin monomers were copolymerized with styrene (ST) and methyl methacrylate (MMA) via a free radical polymerization technique. The overall conversion was kept low (

Synthesis and characterization of organotin containing copolymers: reactivity ratio studies.

Organotin monomers containing dibutyltin groups--dibutyltin citraconate (DBTC) as a new monomer and dibutyltin maleate (DBTM)--were synthesized. Free radical copolymerizations of the organotin monomers with styrene (ST) and butyl acrylate (BA) were performed. The overall conversion was kept low (< or = 15% wt/wt) for all studied samples and the copolymers composition was determined from tin analysis using the Gillman and Rosenberg method. The reactivity ratios were calculated from the copolymer composition using the Fineman-Ross (FR) method. The synthesized monomers were characterized by elemental analysis, 1H-, 13C-NMR and FTIR spectroscopy.