Evaluation of Efficacy of Herbert Bone Screw and Lag Screw in Management of Oblique Mandibular Fractures: A Prospective Randomized Comparative Study.

Purpose: To assess the efficacy of Herbert cannulated bone screw versus Lag screw in fixation of oblique mandibular fractures. Materials and Method: Study composed of two groups of 20 patients each and descriptive statistics were performed with p value set at 0.05 with confidence interval of 95%. Group A was treated by Titanium Lag screws; while, Group B was treated by Titanium Herbert Cannulated Bone Screws for the management of oblique mandibular fractures. Postoperatively, all the patients were evaluated clinically and radiographically by recording the incidence of complications (if any) which included trismus, neurosensory deficit, swelling, infection. Parameters such as occlusal discrepancy, rigid fixation (interfragmentary gap) and duration of surgery were also recorded for all the patients. Results: All the patients were followed for a period of three months. Difference in mouth opening was found to be statistically significant during 1st month follow-up (p-Value-0.002). Postoperatively, the mean interfragmentary gap in Group A was significantly more than Group B (p-Value-0.000). Other parameters like neurosensory deficits, occlusal discrepancies, chewing efficiency, stability of fractured fragments and post-operative complications in terms of swelling, hardware exposure, radiolucency surrounding screw and wound dehiscence did not show any statistically significant difference. Conclusion: The obtained results showed that both lag screws and Herbert cannulated bone screws fulfill the treatment goals of adequate reduction, fixation and stabilization of oblique mandibular fractures. Herbert screws have shown to have better results in terms of interfragmentary gap reduction as compared to lag screws.

Digitally Customized Esthetic Restoration for Restoring Young Permanent Molars: A Novel Approach.

Introduction: Stainless steel crowns (SSCs) are the popular restorative technique for the young permanent first molars treated endodontically. However, these restorations are not esthetically appealing and need replacement once adjacent teeth erupt and occlusion is stabilized. Aim: Digitally customized aesthetic restoration constitutes as a reliable approach for restoring decayed young permanent molars. Materials and methods: Here we present an innovative treatment approach for endodontically treated permanent young molars using a digital workflow with Intraoral scanners (IOS) and computer-aided design/computer-assisted manufacturing (CAD/CAM) fabrication of the restoration. IOSs include scanning of the prepared tooth, its antagonist, and the bite. CAD/CAM preparation of the customized restoration is followed by cementation and follow-up. Result: IOSs are well tolerated by children, easily and swiftly implemented. Digital workflow should be considered for endodontically treated permanent young molars in contrast to prefabricated unaesthetic options. How to cite this article: Gupta G, Gupta DK, Bhat M, et al. Digitally Customized Esthetic Restoration for Restoring Young Permanent Molars: A Novel Approach. Int J Clin Pediatr Dent 2023;16(4):656-658.

A novel circular approach to analyze the challenges associated with micro-nano plastics and their sustainable remediation techniques.

The mismanagement of consumer-discarded plastic waste (CDPW) has raised global environmental concerns about climate change. The COVID-19 outbreak has generated ∼1.6 million tons of plastic waste per day in the form of personal protective equipment (masks, gloves, face shields, and sanitizer bottles). These plastic wastes are either combustible or openly dumped in aquatic and terrestrial environments. Open dumping upsurges emerging contaminants like micro-nano plastics (MNPs) that directly enter the ecosystem and cause severe impacts on flora and fauna. Therefore, it has become an utmost priority to determine sustainable technologies that can degrade or treat MNPs from the environment. The present review assesses the sources and impacts of MNPs, various challenges, and issues associated with their remediation techniques. Accordingly, a novel sustainable circular model is recommended to increase the degradation efficiency of MNPs using biochemical and biological methods. It is also concluded that the proposed model does not only overcome environmental issues but also provides a sustainable secondary resource to meet the sustainable development goals (SDGs).

Post Surgical Outcomes in Paediatric Adenotonsillar Hypertrophy with Obstructive Sleep Apnea: Subjective and Objective Evaluation.

The aim of the study was to determine the post surgical outcomes in pediatric adenotonsillar hypertrophy with OSA using portable polysomnography (PSG), OSA 18 Questionnaire and Quality of life (QoL) scores. Secondly to correlate the subjective outcomes with objective scores of polysomonography. A prospective, single-arm, nonrandomized, single center study was performed at a tertiary care centre on children aged 3-12 years (n = 30) with adenoid hypertrophy/ tonsillar hypertrophy/adenotonsillar hypertrophy and symptoms suggestive of OSA. All subjects underwent appropriate surgical intervention. A portable PSG and OSA 18 questionnaire evaluation was performed pre surgery and 06 weeks post surgery to assess objective and clinical assessment for OSA. The mean age of children enrolled in the study was 8.68 ± 3 years. The mean pre treatment AHI was 12.56 ± 13.16 which improved to 1.72 ± 1.53 post surgery and was statistically significant (p < 0.05, Wilcoxon signed rank test). There was a statistically significant improvement in other PSG indices such as RDI and ODI post surgery also. The mean total symptom score (TSS) and QoL score also showed a statistically significant improvement post treatment (p < 0.05). However there was no correlation between the PSG and OSA 18 questionnaire scores pre and post surgery. Children with OSA like symptoms can undergo a portable polysomnography pre and post surgery to demonstrate severity of OSA and objectively monitor improvement in OSA post treatment. In the absence of availability of PSG, OSA 18 questionnaire is a suitable alternative to monitor disease severity and outcomes. Further studies may plan to include impact of paediatric OSA on other function such as the cardiac, dentition & malocclusion and neurocognitive function.

Association between ideal cardiovascular health and multiple disabilities among US adults, BRFSS 2017-2019.

OBJECTIVES: Cardiovascular health is the leading cause of death and disability in the United States. Our objective was to estimate the association between ideal cardiovascular health (ICVH) and multiple disabilities among US adults stratified into the three age groups of young (18-44 years), midlife (45-64 years), and older adults (≥65 years). STUDY DESIGN: We conducted a cross-sectional analysis using data pooled from the 2017 and 2019 Behavioral Risk Factor Surveillance System (BRFSS). METHODS: Using American Heart Association's seven-component (four ideal behaviors and three ideal health factors) scoring tool, we identified ICVH as a composite score ≥5 and also computed the ideal behavioral (score ≥3) and ideal health factors (score = 3) submetrics. The outcome, single vs multiple disabilities indicator, was defined using US Census's disability domains and analyzed using multinomial regression. RESULTS: For all three groups, the prevalence of multiple disabilities was significantly lower among those meeting ICVH, ideal behavioral, and ideal health factors compared with those that did not. After controlling for covariates, ICVH score ≥5 was associated with lower relative risk of multiple disabilities in all groups. Although both ideal health and ideal behavioral factors were associated with lower relative risk of multiple disabilities among all groups, the reduction in risk was the highest for multiple disabilities and ideal behavioral factors among midlife (relative risk ratio: 0.30, 95% confidence interval: 0.25, 0.36) and older adults (relative risk ratio: 0.40, 95% confidence interval: 0.33, 0.48). CONCLUSION: Adults with less-than-ideal cardiovascular health had a higher relative risk of multiple disabilities. Addressing the risk of multiple disabilities of US adults will require effective promotion of ICVH.

Novel deep transfer learning model for COVID-19 patient detection using X-ray chest images.

Around the world, more than 250 countries are affected by the COVID-19 pandemic, which is caused by the severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2). This outbreak can be controlled only by the diagnosis of the COVID-19 infection in early stages. It is found that the radiographic images are ideal for the fastest diagnosis of COVID-19 infection. This paper proposes an ensemble model which detects the COVID-19 infection in the early stage with the use of chest X-ray images. The transfer learning enables to reuse the pretrained models. The ensemble learning integrates various transfer learning models, i.e., EfficientNet, GoogLeNet, and XceptionNet, to design the proposed model. These models can categorize patients as COVID-19 (+), pneumonia (+), tuberculosis (+), or healthy. The proposed model enhances the classifier's generalization ability for both binary and multiclass COVID-19 datasets. Two popular datasets are used to evaluate the performance of the proposed ensemble model. The comparative analysis validates that the proposed model outperforms the state-of-art models in terms of various performance metrics.

High-fidelity inference of local impurity profiles in C-2W using Bayesian tomography.

In C-2W (also called "Norman") [1], beam-driven field reversed configuration plasmas embedded in a magnetic mirror are produced and sustained in a steady state. A multi-chord passive Doppler spectroscopy diagnostic provides line-integrated impurity emission measurements near the center plane of the confinement vessel with fast time resolution. The high degree of plasma non-uniformity across optical sightlines can preclude direct fitting of the measured line-integrated spectra. To overcome this challenge, local impurity profiles are inferred using Bayesian tomography, a superior analysis technique based on a complete forward model of the diagnostic. The measured emission of O4+ triplet lines near 278.4 nm is modeled assuming two independent populations: thermal and beam ions. Gaussian processes are used to generate and infer local profiles. The inference incorporates details of the geometrical arrangement of the diagnostic, instrument function, intensity calibration, and a noise model. Markov chain Monte Carlo (MCMC) sampling of the posterior distribution of solutions provides high-fidelity uncertainty estimates. The reconstructed O4+ impurity profiles are consistent with data from other diagnostics and show good agreement with expected physics based on previously developed models of biasing circuit and impurity transport.

Helium line ratio imaging in the C-2W divertor.

A 2D imaging instrument has been designed and deployed on C-2W ("Norman") [H. Gota et al., Nucl. Fusion 61, 106039 (2021)] to study the plasma in the expander divertor by simultaneously measuring three neutral helium spectral lines. Ratios of these images, in conjunction with a collisional-radiative model, yield 2D maps of electron temperature and density. Almost the entire radial plasma cross-section (∼60 cm) can be mapped with a spatial resolution ≲1 cm. These data can, in principle, be acquired at 3 kHz. The neutral helium target is provided by a custom-built supersonic gas injector located inside the divertor vessel, which injects helium toward the magnetic axis and perpendicular to the camera sight-cone. Images of helium emission and reconstructed electron density and temperature profiles of the plasma produced from an end gun are presented. Voltages applied to concentric annular electrodes located in the divertors are used to stabilize beam-driven field reversed configuration plasmas. Magnetic field expansion is also employed to thermally isolate electrons from the end electrodes. Measurements of electron temperature and density in the divertor are important in order to study the effects of both the electrostatic biasing and the divertor magnetic field on electron confinement, neutral gas transport, and the overall machine performance.

Utilization of PET/CT Scan in Head and Neck Carcinoma: A Tertiary Care Hospital Experience.

Objective: PET/CT scan has been increasingly used in assessment of Head and Neck cancer prior to treatment for evaluation and for surveillance. In this study we aim to assess the utilization of PET/CT scan at a tertiary care hospital. Methods: Retrospectively data was reviewed of all patients of Head and Neck cancer who underwent PET/CT scan for workup or for follow-up between July 2018 and December 2019. PET/CT scan done in the pre-treatment assessment and post-treatment surveillance were analyzed for its utility. Results: A total of 145 patients were included. The main indication for pre-treatment PET/CT scan was loco-regionally advanced disease (62 of 90 patients, 68.8%). No specific indication was noted in 19 patients (21%). A significant change in treatment decision was seen in pre-treatment patients based on M stage following a PET/CT scan. However, no change was noted on the basis of T or N stage. In the post-treatment surveillance there was a significant correlation of type of recurrence with clinical assessment and indication for PET/CT scan. 37 out of 87 patients (42.5%) underwent PET/CT scan for no specific reason, of which, 07 patients (18.9%) were detected to have distant metastasis. Conclusion: Role of PET/CT in the pre-treatment assessment is very limited and maybe confined to advanced local or regional disease. Post-treatment surveillance with PET/CT scan has a promising role and must be done as a baseline during 1st follow up at 03 months in all patients who have advanced disease and have undergone multi-modality treatment for the same.

Approach to Management of Cerebrospinal Fluid Rhinorrhea: Institutional Based Protocol.

The role of otolaryngologist in the management of CSF rhinorrhea is expanding. It is prudent to evaluate all cases of CSF leak, understand the etiological causes and formalize a working approach to management of such cases to yield better outcome. A retrospective descriptive study of 39 cases of proven CSF rhinorrhea treated at a tertiary care center between January 2014 to August 2019. The data retrieved were analyzed for age, gender, weight, etiology, recurrence of the disease, history of meningitis, nasal or neurosurgical intervention in past, imaging inform of CT and MR cisternography as and when required. This was aimed at understanding the various etiological types of CSF rhinorrhea and work out a management approach. The patients with skullbase tumors who presented with CSF Rhinorrhea were excluded from the study sample. There were 18 cases of spontaneous CSF rhinorrhea and 20 cases of traumatic CSF rhinorrhea. The mean BMI of spontaneous gp was 32.9 ± 2.46 kg/m2 while in traumatic group was 25.7 ± 2.94 kg/m2 and difference was statistically significant. None of the spontaneous CSF rhinorrhea cases showed features of raised ICP preoperatively either clinically or on imaging except empty sella in 14 of 18 cases. 6 of 18 cases of spontaneous category while 01 of 20 cases in traumatic had recurrence and the recurrence rate was significantly (p < 0.05) higher in spontaneous group. In traumatic group 7 were iatrogenic, 8 were occult traumatic and rest were acute traumatic. 4 of traumatic and 1 spontaneous group had history of meningitis and the incidence was 12.8% in our study group. Early identification and localization of CSF fistula is necessary to reduce morbidity and mortality associated with it. Risk of meningitis is high in CSF rhinorrhea especially in traumatic group. The etiology of CSF rhinorrhea has a bearing on the management and spontaneous CSF rhinorrhea has higher rate of recurrence.

Resonance Excitations in

The anomaly in lithium abundance is a well-known unresolved problem in nuclear astrophysics. A recent revisit to the problem tried the avenue of resonance enhancement to account for the primordial ^{7}Li abundance in standard big-bang nucleosynthesis. Prior measurements of the ^{7}Be(d,p)^{8}Be^{*} reaction could not account for the individual contributions of the different excited states involved, particularly at higher energies close to the Q value of the reaction. We carried out an experiment at HIE-ISOLDE, CERN to study this reaction at E_{c.m.}=7.8 MeV, populating excitations up to 22 MeV in ^{8}Be for the first time. The angular distributions of the several excited states have been measured and the contributions of the higher excited states in the total cross section at the relevant big-bang energies were obtained by extrapolation to the Gamow window using the talys code. The results show that by including the contribution of the 16.63 MeV state, the maximum value of the total S factor inside the Gamow window comes out to be 167 MeV b as compared to earlier estimate of 100 MeV b. However, this still does not account for the lithium discrepancy.

Effect of Twin Block Therapy Versus Fixed Functional Appliances on Pharyngeal Airway Space in Skeletal Class II Patients: A Prospective Cephalometric Study.

Background: Class II malocclusion is one of the most common malocclusion with varied prevalence. Functional therapy with appliances like Twin Block or Fixed functional appliances forms the mainstay of treatment in growing Class II patients. These patients might demonstrate narrow airway due to the retrognathic position of the mandible. This study investigated the effects of twin block and fixed functional appliance therapy (Forsus™ FRD) on the pharyngeal airway space in skeletal Class II patients. Methods: Forty patients with Class II malocclusion were selected and divided into two equal groups of 20 patients each for both Twin block and Forsus group. Lateral cephalograms were obtained before and after the functional appliance therapy. Evaluation was done for changes in hyoid bone position, pharyngeal airway dimensions and tongue position. Results: The variables of the study showed better hyoid position in both the groups. In Twin Block group, an increase in hy-apw2 and hy-PoFH suggested anterior positioning of hyoid and a decrease in H-MP and hy-ML indicated superior positioning. In Forsus group an increase in H-H', hy-FH, hy-ML, hy-NL, hy-NSL and hy-OL suggested inferior positioning of hyoid, while an increase in hy-apw2, hy-CVT, hy-PoFH, hy-RL and hy'-tgo indicated anterior positioning of hyoid bone after functional therapy. Conclusion: Both the twin block and Forsus™ FRD improved the position of the hyoid bone after the functional appliance therapy however the changes were not statistically significant. Twin block and Forsus™ had similar effect on the hyoid bone position, pharyngeal dimensions and the tongue position.

Sustainable approach for valorization of solid wastes as a secondary resource through urban mining.

The incessant population has increased the production and consumption of plastics, paper, metals, and organic materials, which are discarded as solid waste after their end of life. The accumulation of these wastes has created growing concerns all over the world. However, conventional methods of solid waste management i.e., direct combustion and landfilling have caused several negative impacts on the environment (releasing toxic chemicals and greenhouse gases, huge land use) besides affecting human health. Therefore, it is requisite to determine sustainable alternative technologies that not only help in mitigating environmental issues but also increase the economic value of the discarded solid wastes. This process is known as urban mining where waste is converted into secondary resources and thereby conserves the natural primary resources. Thus, this review highlights the technological advancements in the valorization process of discarded wastes and their sustainable utilization. We also discussed several limitations of the existing urban mining processes and further the feasibility of valorization techniques was critically analyzed from a techno-economical perspective. This paper recommends a novel sustainable model based on the circular economy concept, where waste is urban mined and recovered as a secondary resource to support the united nations sustainable development goals (SDGs). The implementation of this model will ultimately help the developing countries to achieve the target of SDGs 11, 12, and 14.

Study of Clinical, Hematological and Molecular Characteristics of Patients of Thalassemia and Hemoglobinopathies in Tertiary Care Hospital.

To study clinical, hematological and molecular characteristics of patients of thalassemia and hemoglobinopathies and to correlate the molecular characteristics with clinical and hematological presentations. Material: This observational cross sectional study included 100 patients of age >12 years of all genders with chronic haemolytic anemia and history of multiple blood transfusion. Blood and radiological investigations were done. Clinical, hematological and molecular characteristics were studied. Observation and Clinical: Pallor was present in all cases and icterus in 32% cases. Total 48% of the patients had hepatomegaly and 98% had splenomegaly. Among genotypes, 15% cases had α-thalassemia, 62% had ß thalassemia + 뫧 thalassemia, 7% had HbS hemoglobinopathy, and 16% had HbE hemoglobinopathy. Hematological: Hemoglobin showed significant association with molecular genotypes of thalassemia with lowest being present in ß-thalassemia + 뫧 thalassemia and HbE.MCV showed significant association with molecular genotypes, with HbE having the lowest MCV of 65.5 fl. LDH levels showed a significant association with molecular genotype with highest being in HbS hemoglobinopathy. Molecular Characteristics: Common mutations in compound α-thalassemia were 3.7, 4.2 and 20.5 deletion. As for ß-thalassemia and 뫧 thalassemia, 47 cases had heterozygous type and 15 cases had homozygous types. In ß-thalassemia, the homozygous type showed IVS1- 5(G→C),CD 41/42(→CTT) and IVSII-654(G→T) while heterozygous type showed CD16(→G), CD 41/42(→CTT), IVS1-5(G→C), and IVSII-654(G→T) . In 뫧 thalassemia, the heterozygous type showed 뫧 inversion mutation.In HbS hemoglobinopathy, heterozygous type showed Codon 6(A→T) and compound heterozygous type showed IVS1- 5(G→C) and Codon 6(A→T). In HbE hemoglobinopathy,the homozygous type showed CD26(G→A) and compound heterozygous type showed IVS1-5(G→C) and IVSII 654(G→T). Conclusion: The common thalassemia genotypes observed in our study were α-thalassemia (15%), ß thalassemia + 뫧 thalassemia, (62%) HbS hemoglobinopathy (7%), and HbE hemoglobinopathy (16%). The patients presented with pallor, icterus, hepatomegaly, and splenomegaly which were comparable among all molecular genotypes of thalassemia and hemoglobinopathies. α-thalassemia had compound α-thalassemia with common mutations being 3.7, 4.2 and 20.5 deletion. As for ß-thalassemia and 뫧 thalassemia, 47 cases had heterozygous type and 15 cases had homozygous types. In 뫧 thalassemia, the heterozygous type showed 뫧 inversion mutation in 5 cases. MCH, Retic count, ferritin stores, and peripheral blood smear were similar in all molecular genotypes. Hemoglobin, MCV and LDH showed a significant association with molecular genotypes. Microcytic hypochromic anaemia was commonest among all.The findings of the present study show that the genotypes of thalassemia are characterized by diversity as well as significant genetic heterogeneities.

Comparative effect of micro-osteoperforation and Photo-biomodulation on the rate of maxillary canine retraction: A split mouth randomized clinical trial.

INTRODUCTION: The lengthy duration of comprehensive orthodontic treatment has always been a major concern. Various modalities have been proposed to accelerate the orthodontic tooth movement (OTM) with varying degree of success. However, there is limited literature, comparing the efficiency of two commonly used modalities which are relatively simple, safe and comfortable chair-side procedures to accelerate orthodontic tooth movement viz. Photo-biomodulation (PBM) being non-invasive and micro-osteoperforations (MOPs) being minimally invasive. The aim was to evaluate the comparative effect of PBM and MOPs on the rate of orthodontic tooth movement (OTM). METHODS: In this split mouth study, thirty patients requiring ma-xillary first premolar extraction were randomly allocated for Photo-biomodulation (PBM) on one side and for micro-osteoperforations (MOPs) on other side of maxilla. Separate canine retraction was performed and movement was measured over a three month period. RESULTS: Micro-osteoperforations (MOPs) significantly increased the rate of maxillary canine retraction by 1.1 fold when compared to the Photo-biomodulation (PBM).The MOPs can successfully reduce the comprehensive fixed orthodontic treatment time by around 9% as compared to PBM. CONCLUSIONS: Micro-osteoperforation is a more efficient modality of accelerating tooth movement as compared to Photo-biomodulation which can be used in routine orthodontic practice.

The use of cone beam computed tomography of paranasal sinuses in the investigation and management of rhinosinusitis: a national survey and our 'one-stop' rhinology clinic experience.

OBJECTIVE: Cone beam computed tomography is an imaging technique that can be used for the paranasal sinuses. This study assessed how widely it is used and the impact it has on chronic rhinosinusitis management in the ENT department of one hospital. METHOD: A nationwide survey was conducted to assess the use of cone beam computed tomography throughout ENT UK members. A retrospective analysis of four-year rhinology clinic data for patients presenting with chronic rhinosinusitis symptoms was subsequently performed to assess how many scans were achieved the same day and the subsequent patient management. RESULTS: The survey results indicated that a majority of staff do not use cone beam computed tomography to image sinuses (86.5 per cent), and this was largely because of lack of access (92 per cent). This study assessed 355 cone beam computed tomography requests. Overall, 306 cases had a cone beam computed tomography scan on the same day as their clinic appointment with the majority seen back in clinic during the same hospital attendance for the results. Overall, 97 patients were discharged on the same day. CONCLUSION: This study suggested a lack of awareness and understanding of cone beam computed tomography in managing rhinosinusitis. The 'one-stop' rhinology clinic model offers benefits including reduced patient hospital attendance.

Microbial community in human gut: a therapeutic prospect and implication in health and diseases.

The interest in the working and functionality of the human gut microbiome has increased drastically over the years. Though the existence of gut microbes has long been speculated for long over the last few decades, a lot of research has sprung up in studying and understanding the role of gut microbes in the human digestive tract. The microbes present in the gut are highly instrumental in maintaining the metabolism in the body. Further research is going on in this field to understand how gut microbes can be employed as potential sources of novel therapeutics; moreover, probiotics have also elucidated their significant place in this direction. As regards the clinical perspective, microbes can be engineered to afford defence mechanisms while interacting with foreign pathogenic bodies. More investigations in this field may assist us to evaluate and understand how these cells communicate with human cells and promote immune interactions. Here we elaborate on the possible implication of human gut microbiota into the immune system as well as explore the probiotics in the various human ailments. Comprehensive information on the human gut microbiome at the same platform may contribute effectively to our understanding of the human microbiome and possible mechanisms of associated human diseases.

Measurements of impurity ion temperature and velocity distributions via active charge-exchange recombination spectroscopy in C-2W.

In TAE Technologies' C-2W experiment, electrode biasing is utilized for boundary control of a field-reversed configuration (FRC) plasma embedded in a magnetic mirror. Understanding the underlying physics associated with FRC rotation, stabilization, and heating is crucial for improving machine performance. Impurity ion rotation and temperature are sensitive to biasing effects, and measurements of these quantities can provide insight into important plasma dynamics and overall effectiveness of the biasing system. To this end, a charge-exchange recombination spectroscopy (ChERS) diagnostic was developed and deployed to measure local impurity ion temperature and velocity in the confinement vessel of C-2W. The system utilizes a new diagnostic neutral beam (40 keV, 8.5 A) and a fiber-coupled spectrometer with an image-intensified high-speed camera to measure beam-induced spectral line emission at multiple lines-of-sight. Design details and the first experimental results obtained with this new diagnostic are presented and discussed.