Damage-free dry transfer method using stress engineering for high-performance flexible two- and three-dimensional electronics.

Advanced transfer printing technologies have enabled the fabrication of high-performance flexible and stretchable devices, revolutionizing many research fields including soft electronics, optoelectronics, bioelectronics and energy devices. Despite previous innovations, challenges remain, such as safety concerns due to toxic chemicals, the expensive equipment, film damage during the transfer process and difficulty in high-temperature processing. Thus a new transfer printing process is needed for the commercialization of high-performance soft electronic devices. Here we propose a damage-free dry transfer printing strategy based on stress control of the deposited thin films. First, stress-controlled metal bilayer films are deposited using direct current magnetron sputtering. Subsequently, mechanical bending is applied to facilitate the release of the metal bilayer by increasing the overall stress. Experimental and simulation studies elucidate the stress evolution mechanisms during the processes. By using this method, we successfully transfer metal thin films and high-temperature-treated oxide thin films onto flexible or stretchable substrates, enabling the fabrication of two-dimensional flexible electronic devices and three-dimensional multifunctional devices.

Effect of preoperative chlorhexidine, essential oil, and cetylpyridinium chloride mouthwashes on bacterial contamination during dental implant surgery: A randomized controlled clinical trial.

Background: Although the role of chlorhexidine and other mouthwashes in periodontal therapy has been elucidated, little information is available on their use as routine preoperative mouth rinses before surgery, especially in periodontal procedures such as dental implant surgery. Objective: This study aimed to compare the efficacy of preoperative chlorhexidine, essential oil, and cetylpyridinium chloride mouthwashes in reducing bacterial contamination at the time of implant placement. Materials and Methods: Eligible patients who underwent dental implant surgery were randomly divided into four groups based on the mouthwash used: (1) 0.12 % chlorhexidine, (2) essential oil, (3) cetylpyridinium chloride, and (4) saline (served as the control group). All the patients of each group rinsed preoperatively with 15 mL of the respective mouthwash for 60 s. Saliva samples before (pre) and immediately after rinsing with the mouthwash (post) and after suturing the flap (end) were collected on the day of the implant placement. Real-time quantitative polymerase chain reaction (qPCR) was performed to analyze the samples and quantify the targeted periodontal pathogens using a propidium monoazide (PMA) dye. Results: Forty patients were included in the study. Real-time qPCR demonstrated a significant reduction in the number of pathogens in the saliva samples of the mouthwash groups compared to that of the control group. A statistically significant difference was observed between the groups for the pre-post and pre-end samples (p < 0.001) but not for the post-end samples (p = 0.203). A statistically significant difference was observed between the chlorhexidine, essential oil, and cetylpyridinium chloride mouthwash groups and the saline group (P < 0.001). The bacterial counts significantly differed with and without the use of the PMA dye. Conclusions: Preoperative chlorhexidine, essential oil, and cetylpyridinium chloride mouthwashes can reduce the bacterial load at the time of implant placement, thereby reducing the incidence of implant-related complications.

Synergistic Effect of Manually Assisted Cough During Mechanical Insufflation-Exsufflation in Patients With Spinal Cord Injury.

BACKGROUND: Mechanical insufflation-exsufflation (MI-E) and manually assisted cough are frequently employed cough augmentation methods for enhancing cough efficiency in individuals with cervical spinal cord injury (CSCI). This study aimed to evaluate the synergistic impact of combining manually assisted cough and MI-E on cough peak flow in subjects with CSCI and identify their related factors. METHODS: Fifteen subjects with CSCI with cough peak flow > -270 L/min underwent 5 consecutive days of 5 cough augmentation sessions; cough peak flow during exsufflation and the total insufflation volume (TIV) during insufflation were measured. Only MI-E was administered on days 1 and 5, whereas on days 2-4 one MI-E-only session followed by 3 MI-E and manually assisted cough sessions was implemented followed by a fifth MI-E-only session. The cumulative and carry-over effects of increasing treatment sessions and any associated factor on cough peak flow during MI-E-assisted coughing were assessed using a linear mixed model (LMM) with repetitive air-flow measurements within the same participants. RESULTS: No cumulative or carry-over effects of manually assisted cough and MI-E were shown with the accumulation of treatment days or sessions. The LMM confirmed that using manually assisted cough (-0.283 L/s, P < .001), TIV (-0.045 L/s, P = .002), and the individual manually assisted cough variance (-0.022 L/s, P = .01) significantly influenced cough peak flow. Estimated mean cough peak flows for MI-E with manually assisted cough and MI-E alone were -4.006 L/s (95% CI -4.237 to -3.775) and -3.723 L/s (95% CI -3.953 to -3.492), respectively, surpassing the initial voluntary cough peak flow without MI-E assistance (-1.65 ± 0.53 L/s). CONCLUSIONS: The use of manually assisted cough and amount of TIV correlated with improved cough peak flow, emphasizing the importance of adequate in-expiratory support. No carry-over effect was associated with using manually assisted cough, highlighting the need to combine MI-E with manually assisted cough for each MI-E treatment to achieve optimal cough effectiveness.

Histological and histomorphometric evaluation of alveolar ridge preservation using an allograft and nonresorbable membrane with and without primary closure: A pilot randomized controlled clinical trial.

The aim of this article is to assess the formation of new vital bone (VB) using histomorphometric analysis in alveolar ridge preservation (ARP), with and without primary closure. Eight patients needed bilateral tooth extraction and planned for ARP. All patients had a nonresorbable membrane with freeze-dried bone allograft after the extractions. Biopsies were obtained 6 months after ARP and were evaluated using histomorphometric analysis. The study included 6 males and 2 females, with an average age of 54.2 years (standard deviation, 9.7). The teeth requiring extraction included a bilateral canine (1 case), premolars (5 cases), and molars (2 cases). Histomorphometric values of new VB, residual bone (RB) substitute particles, and marrow tissue formation were 71.1 %, 16.2%, and 9.69% for closed flap and 50.9%, 15.3%, and 8.19 for open flap. P values were 0.066, 0.878, and 0.326, respectively. The present findings indicate that leaving the flap without primary closure did not have any effect on new VB, RB particles, and immature bone marrow compared with closed flap. However, the results favored the closed-flap technique.

Neural Network-Based Multi-Objective Optimization of Adjustable Drawbead Movement for Deep Drawing of Tailor-Welded Blanks.

To improve the formability in the deep drawing of tailor-welded blanks, an adjustable drawbead was introduced. Drawbead movement was obtained using the multi-objective optimization of the conflicting objective functions of the fracture and centerline deviation simultaneously. Finite element simulations of the deep drawing processes were conducted to generate observations for optimization. The response surface method and artificial neural network were used to determine the relationship between variables and objective functions; the procedure was applied to a circular cup drawing of the tailor-welded dual-phase steel blank. The results showed that the artificial neural network had better prediction capability and accuracy than the response surface method. Additionally, the non-dominated sorting-based genetic algorithm (NSGA-II) could effectively determine the optima. The adjustable drawbead with the optimized movement was confirmed as an efficient and effective solution for improving the formability of the deep drawing of tailor-welded blanks.

Volumetric Changes Following Lateral Guided Bone Regeneration.

Resorbable membranes are well described and employed for horizontal guided bone regeneration (GBR). However, the currently available literature does not provide information on the bone volumetric changes during the healing that follows GBR procedures and dental implant placement. Therefore, the aim of this pilot study was to initially analyze the volumetric bone changes after treating pristine edentulous mandibular defects with lateral GBR using freeze-dried bone allograft (FDBA) and collagen resorbable membrane. Six patients were selected for the analysis. Clinical changes in bone volume before and after GBR were measured. In addition, digital volumetric analysis of the augmented ridges was performed preoperatively, as well as 4 and 6 months after the GBR procedure. At the time of dental implant placement, bone cores were collected during the osteotomy for histologic analysis. Data on volume changes showed a mean of 297.5 ± 134 mm3 augmented bone volume at 4 months with 5% ± 3.78% resorption from 4 to ≥ 6 months. Histologic bone core analysis showed 44.9% plusmn; 5.1% mineralization in the area of augmentation. Within the limitations of this pilot study, resorbable membranes exhibited reliability for GBR in intercalated mandibular defects, providing sufficient bone volume gain at ≥ 6 months for implant stabilization and limited resorption during graft healing.

A Comparison of Embryonic Development and Clinical Outcomes between In vitro Oocytes Maturation Using Micro-Vibration System and In vivo Oocytes Maturation in Polycystic Ovarian Syndrome Patients.

BACKGROUND/OBJECTIVES: Mechanical micro-vibration remains insufficient for improving embryo culture conditions in human immature oocytes. This study compared the clinical outcomes and embryo development between germinal vesicle (GV) oocytes with the micro-vibration culture (MVC) system in in vitro maturation (IVM) cycles and in vivo-matured oocytes in controlled ovarian hyperstimulation (COH) cycles in polycystic ovarian syndrome (PCOS) patients. METHODS: This study investigated 152 PCOS patients who underwent 159 fresh embryo transfer cycles, including IVM cycles with embryos derived from GV oocytes and the COH cycles with embryos derived from in vivo-matured oocytes. The IVM cycles were divided into groups according to the culture system used: static culture (SC) and MVC: In the IVM-S group (n = 47), SC was applied during both IVM and in vitro culture (IVC), whereas in the IVM-MV group (n = 44), MVC was applied during both IVM and IVC. For the COH cycles, in the COH-S group (n = 68), SC was applied during IVC. RESULTS: The number of in vitro-matured oocytes was similar in the IVM-S and IVM-MV groups, but the good-quality embryo (GQE; ≥6-cells) rate was significantly higher in the IVM-MV group (p < 0.01). The GQE rate and clinical outcomes of the COH-S group were significantly better than those of the IVM-S group (p < 0.05) but similar to those of the IVM-MV group. CONCLUSION: Compared with the SC system, the MVC system in IVM cycles improves the embryonic quality of GV oocytes and clinical outcomes, resulting in development of potential equivalent to in vivo-matured oocytes.

Differential interleukin-1ß induction by uropathogenic Escherichia coli correlates with its phylotype and serum C-reactive protein levels in Korean infants.

Urinary tract infection (UTI) is one of the most common bacterial infections in infants less than age 1 year. UTIs frequently recur and result in long-term effects include sepsis and renal scarring. Uropathogenic Escherichia coli (UPEC), the most prevalent organism found in UTIs, can cause host inflammation via various virulence factors including hemolysin and cytotoxic necrotizing factors by inducing inflammatory cytokines such as interleukin (IL)-1ß. However, the ability of each UPEC organism to induce IL-1ß production may differ by strain. Furthermore, the correlation between differential IL-1ß induction and its relevance in pathology has not been well studied. In this study, we isolated UPEC from children under age 24 months and infected bone-marrow derived macrophages with the isolates to investigate secretion of IL-1ß. We found that children with higher concentrations of C-reactive protein (CRP) were more likely to harbor phylotype B2 UPEC strains that induced more IL-1ß production than phylotype D. We also observed a significant correlation between serum CRP level and in vitro IL-1ß induction by phylotype B2 UPEC bacteria. Our results highlight the diversity of UPEC in terms of IL-1ß induction capacity in macrophages and suggest a potential pathogenic role in UTIs by inducing inflammation in infants.

A Comparison between Primary and Secondary Flap Coverage in Ridge Preservation Procedures: A Pilot Randomized Controlled Clinical Trial.

AIMS: To assess the bone dimensional changes after extraction and alveolar ridge preservation (ARP) using primary coverage (closed flap technique, CFT) or healing by secondary intention (open flap technique, OFT). MATERIALS AND METHODS: Ten patients (split mouth design) were planned for extraction and ARP. All sites received ARP with freeze-dried bone allograft (FDBA) and nonresorbable membrane after extraction. Clinical standardized measurements were used to assess the dimensional alterations of the alveolar ridge. RESULTS: All patients completed the study, and a total of 20 sites were randomized to CFT or OFT group. Center height (mean difference of 8.1 mm, SD =1.9 CFT, and 7.5 mm, SD= 1.8 OFT) and buccal height (mean difference of 0.8 mm, SD =1.0 CFT, and 0.3 mm, SD= 1.1 OFT) were significantly different within the same group. However, there was no statistically significant difference between groups. In the OFT group, the keratinized tissue width was higher and the pain VAS scores at 24 hours were lower compared with the CFT (p = 0.004 and p = 0.006, respectively). CONCLUSIONS: Leaving the flap open did not have any effects on the dimensional changes of bone height or width. However, there was a wider band of keratinized tissue and less pain with the CFT compared with the OFT. The study protocol was registered at ClinicalTrials.gov, Identifier NCT03136913.

Prospective study of the impact of peri-implant soft tissue properties on patient-reported and clinically assessed outcomes.

BACKGROUND: It has been proposed that the presence of a zone of keratinized mucosa (KM) around implants is associated with less discomfort during brushing and improved esthetic outcomes. Therefore, mucogingival procedures have been recommended for patients with discomfort during brushing, and to enhance esthetic results around implants without KM. However, no study has systematically assessed and compared discomfort during brushing, patient soft tissue esthetic satisfaction, and other clinical parameters between implants with and without KM. METHODS: Group 1 included patients with implants surrounded by KM, whereas patients in Group 2 had no KM around implants. Patient discomfort during brushing and esthetic satisfaction were measured with a visual analog scale and compared between the 2 groups using a mixed model. Clinical width of KM, probing depth, peri-implant recession, plaque index, and bleeding on probing were compared within and between groups 3 and 6 months following implant restoration. RESULTS: Twenty-four patients (12 in each group) were evaluated at the 3- and 6-month follow-up visits. Patients without peri-implant KM were less satisfied with the esthetics of the soft tissue around their implants (P < 0.01). However, lack of KM was not associated with discomfort during brushing. In Group 1, width of KM was significantly increased after 6 months (P < 0.01). There was greater recession around implants without KM after 3 months (P < 0.01), but not after 6 months. CONCLUSIONS: Patients reported that presence or absence of keratinized mucosa did not affect discomfort associated with brushing. Yet, esthetically, patients preferred implants with a zone of keratinized mucosa.

Retrospective study of single vitrified-warmed blastocyst transfer cycles according to the presence of morphokinetic variables.

This study retrospectively assessed whether time-lapse data relating to developmental timing and morphology were associated with clinical outcomes, with the eventual goal of using morphokinetic variables to select embryos prospectively for cryopreservation. In this study, we examined the clinical outcomes of single vitrified-warmed blastocyst transfer cycles that were cultured in a time-lapse incubation system. The morphokinetic variables included uneven pronuclei, an uneven blastomere, multinucleation, and direct, rapid, and irregular division. A total of 164 single vitrified-warmed blastocyst transfer cycles were analyzed (102 cycles of regularly developed blastocysts and 62 cycles of blastocysts with morphokinetic variables). No significant differences in the age of females or the standard blastocyst morphology were found between these two groups. The regularly developed blastocysts showed significantly higher implantation and clinical pregnancy rates than the blastocysts exhibiting morphokinetic variables (30.4% vs. 9.7% and 37.3% vs. 14.5%, respectively; p<0.01). The blastocysts that exhibited morphokinetic variables showed different mean development times compared with the regularly developed blastocysts. Although morphokinetic variables are known to have fatal impacts on embryonic development, a considerable number of embryos developed to the blastocyst stage. Morphokinetic variables had negative effects on the implantation and clinical pregnancy rates in vitrified-warmed blastocyst transfer cycles. These findings suggest that blastocysts cultured in a time-lapse incubation system should be considered for selective cryopreservation according to morphokinetic variables.

Bone Resorption During Submerged Healing After Guided Bone Regeneration: A Prospective Case Series.

OBJECTIVE: The aim of this study was to evaluate bone resorption quantitatively during the healing period subsequent to ridge augmentation. MATERIALS AND METHODS: Sixteen patients requiring vertical ridge augmentation before implant placement were recruited in the study. The study used an allograft and nonresorbable membrane. A custom acrylic stent was used to measure changes in bone volume. Augmented bone was compared with remaining bone 6 months after guided bone regeneration (α = 0.05 by means of the paired t test). RESULTS: All sites following the six months post-surgery were analyzed. Overall changes in alveolar bone were observed with a mean resorption rate of 19.8% (p<0.001). The vertical bone measurement indicated a mean resorption rate of 22.8% (range = 18.5% - 26.5%). The horizontal measurement indicated a mean resorption rate of 18.7% (range = 12.6% - 26.0%). Among the sixteen sites, four sites with post-operative complications including membrane exposure showed an average of 42.1% resorption rates. CONCLUSION: Loss in graft quantity was observed after ridge augmentation using an allograft and nonresorbable membrane during submerged healing before implant placement. Further studies with larger sample sizes are recommended to confirm its findings.

Association Between Sinus Membrane Thickness and Membrane Perforation in Lateral Window Sinus Augmentation: A Retrospective Study.

BACKGROUND: Association between Schneiderian membrane thickness and membrane perforation is examined in lateral window sinus augmentation. METHODS: This retrospective study reviewed records of 551 patients who underwent lateral sinus augmentation at Tufts University School of Dental Medicine, Boston, Massachusetts, from June 1, 2006 to May 31, 2015. Preoperative cone-beam computed tomography images were analyzed to evaluate possible association among membrane thickness, residual bone height, and membrane perforation. Data were evaluated using Mann-Whitney U test at P <0.05. RESULTS: Total 167 patients (95 males and 72 females) met the eligibility criteria and were included in the study. Among them, 47 patients had Schneiderian membrane perforation (perforation group). Mean membrane thickness was 0.84 ± 0.67 mm in the perforation group and 2.65 ± 4.02 mm in the non-perforation group. There was a statistically significant difference in membrane thickness between groups (P <0.001). Mean residual ridge thickness was 2.78 ± 1.37 mm in the perforation group and 4.21 ± 2.09 mm in the non-perforation group. There was a statistically significant difference in residual alveolar bone height (P <0.001). CONCLUSIONS: Patients who experienced membrane perforation had a thinner membrane compared with patients without membrane perforation. Schneiderian membrane perforation was associated with decreased residual bone height.

Use of Allograft with Platelet Concentrate in the Treatment of Multiple Miller Class III Gingival Recession Defects: Report of Three Cases.

Three patients with multiple Miller Class III recession defects with substantial bone loss were treated with hard tissue augmentation with the goal to prevent future recessions. The surgery involved a full-thickness mucoperiosteal coronally advanced flap, bone grafting, and primary flap closure. Freeze-dried bone allograft (FDBA) in combination with plasma rich in growth factors (PRGF) was grafted during the procedure. After more than 6 months, the treated sites showed soft tissue maturation and esthetic tissue blending. Clinically, an increase in convexity of alveolar ridge and soft tissue was observed, as well as a marked reduction in recession depth and gain in width of keratinized mucosa. Cone beam computed tomography showed a gain in buccal bone thickness. The use of FDBA in combination with PRGF appears to have potential for the treatment of Miller Class III defects by providing improved hard and soft tissue profiles.

Comparison of static culture, micro-vibration culture, and micro-vibration culture with co-culture in poor ovarian responders.

OBJECTIVE: This study was conducted to compare the effects of static culture, dynamic culture, and the combination of dynamic culture with specialized surfaces involving co-culture on human embryonic development. Embryos cultured using conventional static culture (SC) techniques served as a control group. We compared dynamic culture using micro-vibration culture (MVC) and micro-vibration with co-culture (MCoC), in which autologous cumulus cells were used as a specialized surface. METHODS: We conducted a chart review of patients who were treated between January 2011 and November 2014 in order to compare embryonic development rates and pregnancy rates among the groups. Zygotes were cultured in micro-droplets, and embryos were subsequently selected for transfer. Some surplus embryos were cryopreserved, and the others were cultured for blastocyst development. A micro-vibrator was set at the frequency of 42 Hz for duration of 5 seconds per 60 minutes to facilitate embryo development. RESULTS: No significant differences among the groups were present in patient's characteristics. However, the clinical pregnancy rates were significantly higher in the MVC group and the MCoC group than in the SC group. No significant differences were found in the blastocyst development rate between the SC group and the MVC group, but the blastocyst development rate in the MCoC group was significantly higher than in the SC and MVC groups. CONCLUSION: The clinical pregnancy rate was significantly increased by the application of micro-vibration to the embryonic cultures of poor responders. The blastocyst development rate was significantly increased by the application of MCoC to surplus embryos.

A retrospective study of single frozen-thawed blastocyst transfer.

OBJECTIVE: To study the clinical outcomes of single frozen-thawed blastocyst transfer cycles according to the hatching status of frozen-thawed blastocysts. METHODS: Frozen-thawed blastocysts were divided into three groups according to their hatching status as follows: less-than-expanded blastocyst (≤EdB), hatching blastocyst (HgB), and hatched blastocyst (HdB). The female age and infertility factors of each group were evaluated. The quality of the single frozen-thawed blastocyst was also graded as grade A, tightly packed inner cell mass (ICM) and many cells organized in the trophectoderm epithelium (TE); grade B, several and loose ICM and TE; and grade C, very few ICM and a few cells in the TE. The clinical pregnancy and implantation rate were compared between each group. The data were analyzed by either t-test or chi-square analysis. RESULTS: There were no statistically significant differences in average female ages, infertility factors, or the distribution of blastocyst grades A, B, and C in each group. There was no significant difference in the clinical pregnancy and implantation rate of each group according to their blastocyst grade. However, there was a significant difference in the clinical pregnancy and implantation rate between each group. In the HdB group, the clinical pregnancy and implantation rate were similar regardless of the blastocyst quality. CONCLUSION: There was an effect on the clinical outcomes depending on whether the blastocyst hatched during single frozen-thawed blastocyst transfer. When performing single frozen-thawed blastocyst transfer, the hatching status of the frozen-thawed blastocyst may be a more important parameter for clinical outcomes than the quality of the frozen-thawed blastocyst.