Masseter Muscle Thickness in Relation to Facial Form in Angle's Normal Occlusion and Malocclusions: An Observational Study.

Background: Various clinical studies performed in adults have shown the relationship between craniofacial morphology and masticatory muscle function. However, the growth of the masticatory muscle has not received such attention, when compared with the volume of studies on the skeletal growth of face. With this background and considering the widespread use of ultrasonography (USG), the following study was undertaken to provide some insights into the relationship between muscle and bone and facial morphology. Methods: This was a prospective, observational study conducted over a period of three years from 2012 to 2015 to assess the correlation between the thickness of the masseter muscle in Angle's normal occlusion and the various malocclusions of the dental arch as well as the facial form. Patients with a full complement set of teeth, normal tooth morphology, Angle's normal occlusion, Angle's class I-III malocclusion, those with a history of third molar extraction, and impaction were included in the study. Those with a history of any prior orthodontic treatment, restorations, or any missing teeth (except the third molar) were exempted from the study. The greater thickness of masseter muscle in relaxed and clenched state was recorded on USG. Facial morphology was determined with the aid of facial photographs. Results: The study was conducted on 140 patients. The class I normal occlusion group had the thickest masseter muscle, while the class III malocclusion group had the thinnest masseter muscle. Facial parameters showed highly significant gender-wise differences in class I normal occlusion, class I malocclusion, and class II division II malocclusion. There was a significant negative co-relation between the thickness of masseter muscle and facial forms in all the categories of Angle's classification as indicated by a negative regression coefficient B (P < 0.05). Conclusion: The masseter muscle thickness correlated directly with male gender and normal occlusion, and inversely with the degree of malocclusion and facial form.

Effect of planning interventions on parent supervised oral health behaviors in primary school age children: a randomized controlled trial.

OBJECTIVE: To compare effect of planning interventions on self-reported changes in parents supervised oral health related behaviours (OHRBs) and associated clinical oral health parameters for 'primary school age' children. METHODS: 110 parent-child pairs (children aged 3-8 years) were randomly assigned to either of the two groups. In 'Action planning' group (AP), parent participants of the pair were asked to make 'action plan' within "how, when, where" format for their child OHRBs. In 'Implementation Intention' (IMI) group, parents were asked to form an 'if-then plan' to improve OHRBs for their child. Self-reported changes on target OHRBs, change in plaque scores, change in plaque stagnation areas and change in caries status of tooth surfaces were observed at 2, 8, 12 weeks. RESULTS: Overall OHRBs scores changed significantly from baseline to 12 weeks for both interventions. But the scores were significantly better with 'if-then' planning than 'action planning' (z=4 p=<0.001) at 12 weeks. Plaque scores also changed significantly from baseline to 12 weeks for both interventions but improved significantly with 'if-then' planning (16.20±5.24) than 'action planning' (50.655±11.24) at 12 weeks. Number of plaque stagnation areas also changed significantly from baseline to 12 weeks for both interventions but improved significantly with if-then' planning at 12 weeks (12.80±5.33) than 'action planning' (42.76±10.34) (t=-11.55 p=<0.001). There was significant change in caries status of sound tooth surfaces with 'action planning' at 12 weeks (z=116.5 p=0.023). There were no new carious lesions reported with 'ifthen' planning at 12 weeks. CONCLUSION: The study observed significant improvement in OHRBs and associated oral health parameters with planning interventions preferring 'if-then' planning over 'action planning'. It also elicited significant barriers to behaviours in action.

Comparative assessment of cleaning efficacy of two exclusive paediatric rotary files in root canals of primary teeth: An in vitro study.

BACKGROUND: Paediatric rotary file systems have recently been developed for primary teeth use. AIM: To study the cleaning efficacies of two paediatric rotary endodontic files, the Prime PedoTM , and the Kedo-SG BlueTM against the standard H files. DESIGN: This in vitro study included 54 freshly extracted primary molars, which were randomised into three groups (n = 18 each) and were prepared using either Kedo-SG BlueTM , Prime PedoTM or hand H files after injecting methylene blue dye into the canals. Pre- and post-operative cone beam computerised tomography (CBCT) was performed to assess change in root canal volumes. Methylene blue dye removal from canals was assessed using stereomicroscopy, and canal cleanliness was examined by scanning electron microscopy (SEM). RESULTS: Both Prime PedoTM and Kedo-SG BlueTM files reduced significantly less dentine when compared with conventional hand filing with Prime PedoTM removing the least amount of dentine. No significant difference was found in median SEM scores among the groups in the cervical, middle and apical thirds of the roots. Stereomicroscopic assessment of root canal cleanliness using dye removal technique shows a statistically significant difference existing between Kedo-SG BlueTM and hand H files groups. CONCLUSION: Prime PedoTM removed the least amount of dentine. Kedo-SG BlueTM performed significantly better than conventional hand filing with H files when the root canal cleanliness was assessed.

Identification and management of foreign body in the primary teeth.

Paediatric dentists encounter many emergencies in child patients and entrapment of foreign bodies in teeth is a commonly anticipated complication. It is more frequently seen in children with chronic carious lesions or due to teeth with wide open pulp chambers and pulp canals affected with caries or traumatic dental injuries. Here, we report a case of successful management of foreign body lodgement in the primary teeth of a middle childhood female patient along with a literature review of various foreign bodies identified in the past and some practical recommendations for the prevention of such incidents in the future.

Shear bond strengths of bur or Er:YAG laser prepared dentine to composite resin with or without low-level laser conditioning: an in vitro study.

This study aims to compare the different modes of cavity preparation while evaluating the effect of low-level laser therapy (LLLT) on dentine before bonding in terms of shear bond strength between composite resin and dentine. Fifty human molar teeth were mounted on acrylic blocks and dentine specimen were prepared after which they were randomized into four equal groups. Cavity preparation mode differed in respective groups. After etching, bonding; composite resin was placed and polymerized on the prepared dentine surfaces. The specimens were kept in an environment simulating oral cavity and then shear tested in a universal testing machine. The failure surfaces of the specimen teeth were subjected to SEM micrographic evaluation. The cavity prepared with diamond abrasive points had a higher shearing load at failure that was statistically significantly different from the ones prepared with laser. That with diamond abrasive points followed by LLLT of the cavity surface with Nd:YAG laser had a higher bond strength than the ones prepared with just Er:YAG laser and there was no statistically significant difference between these and the ones prepared with diamond abrasive points alone. SEM analysis of the failure mode in bur-cut dentine showed the presence of a hybrid layer at the interface. Surface conditioning of the same with Nd:YAG laser before etching suggested a recrystallisation of dentine due to the heat produced. Cavity preparation with Er:YAG laser leads to reduced shear bond strength to adhesive restorative materials when compared with that using burs and high-speed handpiece.

Comparative evaluation of intranasal midazolam-ketamine, dexmedetomidine-ketamine, midazolam-fentanyl, and dexmedetomidine-fentanyl combinations for procedural sedation and analgesia in pediatric dental patients: a randomized controlled trial.

Background: In order to assess the effectiveness of various analgesio-sedative combinations for pain relief and sedation in pediatric dental patients, a thorough evaluation of clinical studies and patient outcomes is necessary. Methods: A total of 128 healthy, uncooperative pediatric dental patients were randomly allocated to receive one of the four combinations of drugs via the intranasal (IN) route: Group I received midazolam-ketamine (MK), Group II received dexmedetomidine-ketamine (DK), Group III received midazolam-fentanyl (MF), and Group IV received dexmedetomidine-fentanyl (DF) in a parallel-arm study design. The efficacy and safety of the combinations were evaluated using different parameters. Results: The onset of sedation was significantly faster in the DF group than in the DK, MF, and MK groups (P < 0.001). The depth of sedation was significantly higher in the DK and DF groups than in the MK and MF groups (P < 0.01). DK and DF produced significant intra- and postoperative analgesia when compared with combinations of MK and MF. No significant adverse events were observed for any of the combinations. Conclusions: The DK and DF groups showed potential as analgesio-sedatives in view of their anxiolytic and analgesic effects.

Management of infected radicular cyst associated with immature maxillary permanent lateral incisor: a conservative surgical approach.

Radicular cysts are the most common cystic lesions which affect the jaw. Traumatic dental injuries cause injury to the periodontal ligament and dental pulp often leads to pulpal necrosis. The necrosed pulp eventually becomes the nidus of infection and irritates the periapical epithelial cell remnants, which in turn develops into a cyst eventually. This case report presents the successful conservative surgical management of a large infected radicular cyst which was associated with traumatised, necrotic, permanent maxillary lateral incisor with open apex by Partsch II surgical procedure followed by a combination of retrograde and orthograde root canal obturation. This report will guide the clinicians in the arena of surgical endodontics in a conservative approach.

Transcriptome Analysis Revealed Osmoregulation Related Regulatory Networks and Hub Genes in the Gills of Hilsa shad, Tenualosa ilisha, during the Migratory Osmotic Stress.

Tenualosa ilisha (Hilsa shad), an anadromous fish, usually inhabits coastal and estuarine waters, and migrates to freshwater for spawning. In this study, large-scale gill transcriptome analyses from three salinity regions, i.e., fresh, brackish and marine water, revealed 3277 differentially expressed genes (DEGs), out of which 232 were found to be common between marine vs freshwater and brackish vs freshwater. These genes were mapped into 54 KEGG Pathways, and the most significant of these were focal adhesion, adherens junction, tight junction, and PI3K-Akt signaling pathways. A total of 24 osmoregulatory genes were found to be differentially expressed in different habitats. The gene members of slc16 and slc2 families showed a dissimilar pattern of expressions, while two claudin genes (cldn11 & cldn10), transmembrane tm56b, and voltage-gated potassium channel gene kcna10 were downregulated in freshwater samples, as compared to that of brackish and marine environment. Protein-protein interaction (PPI) network analysis of 232 DEGs showed 101 genes to be involved in PPI, while fn1 gene was found to be interacting with the highest number of genes (36). Twenty-five hub genes belonged to 12 functional groups, with muscle structure development with seven genes, forming the major group. These results provided valuable information about the genes, potentially involved in the molecular mechanisms regulating water homeostasis in gills, during migration for spawning and low-salinity adaptation in Hilsa shad. These genes may form the basis for the bio-marker development for adaptation to the stress levied by major environmental changes, due to hatchery/culture conditions.

Anthropogenic risk assessment of riverine habitat using geospatial modelling tools for conservation and restoration planning: a case study from a tropical river Pranhita, India.

The riverine ecosystem provides multiple benefits to human community and contributes to the sustainable development of the ecoregion. The growing dependency on these ecosystems has largely contributed to aggravating the ecological risks, habitat degradation, and loss of ecosystem services. The present study evaluates the ecological risk emanating from nine anthropogenic stressors including river use, hydro-morphology, catchment pollution, and biological stressor on river Pranhita in Godavari Basin of Peninsular India using InVEST (Integrated Valuation of Ecosystem Services and Tradeoffs) Habitat Risk Assessment model. The primary field survey, remote sensing, and secondary data-assisted spatial modelling results revealed low ecological risk (R = 0.65 of 3) in river Pranhita due to anthropogenic activities. Sediment loading, the inflow of nitrogen, and habitat fragmentation were the major stressors with relatively higher risk score (> 1); influence on a sizeable portion of riverine habitat (29-75% of the total area under high-risk zone) indicates the mounting threat from catchment activities. The low-risk value observed in protected river reaches as compared to unprotected areas is likely to be influenced by the abundant presence of intact riparian vegetation which mitigate the catchment stressors and minimal anthropogenic activity within protected areas. This study demonstrates the application of InVEST HRA model for ecological risk assessment of riverine ecosystems and fish assemblages along with their input data generation framework. This has the potential for prioritization of sensitive habitats based on computed ecological risk and stressor identification based on their exposure and consequences for developing appropriate mitigation measures. This model is spatially explicit and accommodates user-defined criteria for ecosystem-level assessment at a regional and national scale to facilitate the resource managers and policymakers for conservation and restoration planning and implementation of targeted management measures for sustainable development.

Complete mitochondrial genome of golden variant of freshwater fish Labeo rajasthanicus (Cypriniformes: Cyprinidae): endemic to India.

The complete mitochondrial genome of the freshwater fish species Labeo rajasthanicus was obtained, using Illumina NovaSeq 6000 with 2 × 150 bp paired-end sequencing. The mitogenome of L. rajasthanicus is 16,738 bp in length (GenBank accession no.: OQ834146), comprised of 13 protein-coding genes, 22 tRNA genes, two rRNA genes, and a control region, i.e. D-loop. The arrangement of genes was found to be identical to other Cypriniformes fish mitogenome, available in the NCBI database. The taxonomic status of L. rajasthanicus as a valid species was debated by some researchers and it was considered a synonym of L. boggut. However, phylogenetic analysis in the present study supports the species validity of L. rajasthanicus, as it showed a distinct node well separated from L. boggut and supported by a high bootstrap value. Furtherly, the pairwise genetic divergence among studied species showed the divergence between L. rajasthanicus and L. boggut as 1.6% whereas the minimum divergence was found to be 0.13% with L. dussumieri followed by L. fimbriatus (0.58%) and L. gonius (0.63%). The complete mitogenome of L. rajasthanicus will also be useful as a baseline reference genome for the reconstruction and annotation of the mitogenome of other Labeo species.

SkiNet: A deep learning framework for skin lesion diagnosis with uncertainty estimation and explainability.

Skin cancer is considered to be the most common human malignancy. Around 5 million new cases of skin cancer are recorded in the United States annually. Early identification and evaluation of skin lesions are of great clinical significance, but the disproportionate dermatologist-patient ratio poses a significant problem in most developing nations. Therefore a novel deep architecture, named as SkiNet, is proposed to provide faster screening solution and assistance to newly trained physicians in the process of clinical diagnosis of skin cancer. The main motive behind SkiNet's design and development is to provide a white box solution, addressing a critical problem of trust and interpretability which is crucial for the wider adoption of Computer-aided diagnosis systems by medical practitioners. The proposed SkiNet is a two-stage pipeline wherein the lesion segmentation is followed by the lesion classification. Monte Carlo dropout and test time augmentation techniques have been employed in the proposed method to estimate epistemic and aleatoric uncertainty. A novel segmentation model named Bayesian MultiResUNet is used to estimate the uncertainty on the predicted segmentation map. Saliency-based methods like XRAI, Grad-CAM and Guided Backprop are explored to provide post-hoc explanations of the deep learning models. The ISIC-2018 dataset is used to perform the experimentation and ablation studies. The results establish the robustness of the proposed model on the traditional benchmarks while addressing the black-box nature of such models to alleviate the skepticism of medical practitioners by incorporating transparency and confidence to the model's prediction.

Non-surgical management of a large periapical lesion with internal resorption using PRF, hydroxyapatite and MTA.

Periapical lesions of endodontic origin are caused by microbial infection of pulp. According to various studies, it is known that necrosis of pulp provides a favourable habitat for microbes to replicate and release various toxins into the periapical tissue leading to inflammation and formation of a periapical lesion. A variety of non-invasive methods to manage such lesions include conservative root canal treatment, aspiration-irrigation technique, decompression technique, calcium hydroxide therapy, lesion sterilisation and tissue repair therapy, and the apexum procedure. We present a case report describing non-surgical management of a large periapical lesion associated with a permanent central incisor displaying internal inflammatory resorption using platelet rich fibrin (PRF), bone graft and mineral trioxide aggregate (MTA).

Conservative management of long-standing traumatised maxillary central incisor with incomplete apex and severe internal resorption using triple antibiotic paste, mineral trioxide aggregate and fiber-reinforced composite.

Traumatic dental injuries result in damage to many dental and periradicular structures. They can be conservatively managed depending on the extent of the injury. Maxillary central incisors are most commonly involved in traumatic dental injuries mainly because of their anterior and protrusive positioning. The treatment of immature permanent teeth with severe internal resorption poses a lot of challenges to the clinician. The objective of the present article is to report successful management of traumatised maxillary central incisor with incomplete root formation and severe internal resorption in a 10-year-old boy using triple antibiotic paste, mineral trioxide aggregate and fibre-reinforced composite.

Discovery of alternatively spliced isoforms and long non-coding RNA in full length brain transcriptomes of anadromous Hilsa shad, Tenualosa ilisha (Hamilton, 1822).

BACKGROUND: Full length transcriptomes, achieved through long-read sequencing, along with the isoform analysis can reveal complexities in the gene expression profiles, as well as annotate the transcriptomes of non-model organisms. METHODS AND RESULT: Full length transcripts of brain transcriptome of Tenualosa ilisha, Hilsa shad, were generated through PacBio single molecule real-time sequencing and were characterized. A total of 8.30 Gb clean reads were generated, with PacBio RSII, which resulted in 57,651 high quality consensus transcripts. After removing redundant reads, a total of 19,220 high-quality non-redundant transcripts and 17,341 full length ORF transcripts were classified to 7522 putative ortholog groups. Genes involved in various neural pathways were identified. In addition, isoform clusters and lncRNAs were discovered, along with Hilsa specific transcripts with coding frames and 29,147 SSRs in 944 transcripts (1141 annotated). CONCLUSION: The present study provided, for the first time, a comprehensive view of the alternative isoforms of genes and transcriptome complexity in Hilsa shad brain and forms a rich resource for functional studies in brain of this anadromous fish.

Effect of Surface Roughness on Hydrodynamic Characteristics of an Impinging Droplet.

The influence of surface roughness and impact energy on the hydrodynamic behavior of water droplets impinging upon dry and rigid surfaces of known roughness has been investigated experimentally. The influence of these two parameters on the droplet maximum spreading diameter, slip length during droplet recoil, dynamic contact angle, contact angle hysteresis, and apparent contact angle of droplets at rest has been determined. Based on the quantitative assessment, a correlation for the maximum spreading diameter in terms of the nondimensional parameter (We/Oh) and surface roughness ratio (Ra/do) was derived. We propose to use surface roughness "Ra" rather than using the contact angle for correlation as contact angles cannot be known a priori, whereas surface roughness can be determined beforehand. The wetting state of a droplet depends on the combined influence of droplet impact energy and surface roughness. While increasing impact energy increases the spreading, higher surface roughness resists the droplet from spreading. Low impact energy and a smoother surface tend toward the Cassie-Baxter wetting state, whereas high impact energy and rough surfaces propel the droplet toward the Wenzel state of wetting.

COVIDScreen: explainable deep learning framework for differential diagnosis of COVID-19 using chest X-rays.

COVID-19 has emerged as a global crisis with unprecedented socio-economic challenges, jeopardizing our lives and livelihoods for years to come. The unavailability of vaccines for COVID-19 has rendered rapid testing of the population instrumental in order to contain the exponential rise in cases of infection. Shortage of RT-PCR test kits and delays in obtaining test results calls for alternative methods of rapid and reliable diagnosis. In this article, we propose a novel deep learning-based solution using chest X-rays which can help in rapid triaging of COVID-19 patients. The proposed solution uses image enhancement, image segmentation, and employs a modified stacked ensemble model consisting of four CNN base-learners along with Naive Bayes as meta-learner to classify chest X-rays into three classes viz. COVID-19, pneumonia, and normal. An effective pruning strategy as introduced in the proposed framework results in increased model performance, generalizability, and decreased model complexity. We incorporate explainability in our article by using Grad-CAM visualization in order to establish trust in the medical AI system. Furthermore, we evaluate multiple state-of-the-art GAN architectures and their ability to generate realistic synthetic samples of COVID-19 chest X-rays to deal with limited numbers of training samples. The proposed solution significantly outperforms existing methods, with 98.67% accuracy, 0.98 Kappa score, and F-1 scores of 100, 98, and 98 for COVID-19, normal, and pneumonia classes, respectively, on standard datasets. The proposed solution can be used as one element of patient evaluation along with gold-standard clinical and laboratory testing.

Microsatellite marker development in Spanish mackerel Scomberomorus commerson using third generation sequencing technology.

Spanish mackerel S. commerson belonging to family Scombridae, represent a group of highly commercial marine fisheries with an ever-growing demand world over. Analysing the genetic diversity of this species is of utmost importance and necessary for conservation purposes. Microsatellites are molecular tools with advantages that are ideal for population analyses. This study provides the first multiplex panel set of species-specific microsatellite loci for S. commerson that can be applied when assessing both intra- and inter population genetic variation. Microsatellite marker panels were developed in S. commerson, using Third Generation Sequencing technology in PacBio RSII, based on Single-Molecule Real-Time (SMRT). Thirty- two microsatellite loci were isolated and characterized for S. commerson, by genotyping 20 individuals each obtained from the Kochi and Veraval in the Arabian sea and Chennai along Bay of Bengal coast (n = 3). The number of alleles per locus in S. commerson varied from 4 to 17, while the mean observed and expected heterozygosities ranged from 0.656 to 0.753. The Polymorphic Information Content (PIC) were highly informative, 85% loci with PIC value 0 > 0.75. This suite of markers provides the first species specific nuclear multiplex microsatellite marker panels (32 loci) for S. commerson and thus allows assessment of different populations structures of the species across its distribution range, with more specificity. These newly developed loci have also been validated for cross transferability in another scomberid fish Scomberomorus guttatus.

Reflective learning for behavioral guidance in pediatric dentistry.

INTRODUCTION: Basic behavioral guidance (BBG) skills help in delivery of quality health care in pediatric dentistry. The complex nature of these skills, warrants analyzing actions performed. An appropriate scientific way to do this is by "reflection." Hence, the present study was designed to introduce "reflection of action" as means for learning BBG skills by undergraduates in pediatric dentistry. METHODS: Participants (dental undergraduate) performed oral prophylaxis (two visits) in pediatric patients (age 3-7 years) with application of BBG skills, under video recording. They were instructed regarding "reflection on action." The learners then reviewed own videos and wrote reflections. Reflections were assessed on Boud's 4R framework and feedback was given by the faculty. Reflective writing was repeated for a second visit. Knowledge of the learners in using reflections for learning was assessed by retrospective pretest posttest questionnaire. Video recordings were scored for BBG skills. Acceptability of the intervention was addressed by satisfaction questionnaire. RESULTS: There was a significant improvement in the knowledge of participants in using reflections for learning these skills. All participants were able to "revisit" (R1 level under Boud's 4R framework) patient encounter in their written reflections. Sixteen participants exhibited shift toward higher levels in the next visit. Video scores of learners also improved significantly over both visits. Students were satisfied with the content, delivery, and relevance of the new educational intervention. CONCLUSION: The strong need of improving BBG skills in pediatric dentistry was met by "reflection on action." There was improvement in the knowledge of students in using reflections for learning and application of behavior guidance skills and was well accepted.

Mitochondrial DNA markers reveal genetic connectivity among populations of Osteoglossiform fish Chitala chitala.

Genetic diversity and population structure in Indian featherback fish, Chitala chitala (Hamilton, 1822) was investigated by combined analyses of two full mitochondrial genes, ATPase 6/8 and Cytochrome b. A total of 403 individuals, collected from 14 rivers yielded 61 haplotypes. Hierarchical partitioning analysis identified 19.01% variance 'among' and 80.99% variance 'within groups and populations'. The mean coefficient of genetic differentiation (FST) was observed to be significant 0.26 (p < 0.05). Mantel tests rejected the hypothesis that genetic and geographic distances were correlated. The patterns of genetic differentiation, AMOVA and principal coordinate analyses indicated that natural populations were sub-structured and comprised of four genetic stocks of C. chitala in Indian rivers. The results also supported the higher resolution potential of concatenated gene sequences. The knowledge of genetic variation and divergence, from this study, can be utilized for its scientific conservation and management in the wild.

Population connectivity and genetic structure of Asian green mussel, Perna viridis along Indian waters assessed using mitochondrial markers.

Perna viridis (Linnaeus, 1758), the Asian green mussel, belonging to the family Mytilidae is widely distributed along the Indian coast. The species is majorly found in southeastern countries and is considered an ideal candidate for aquaculture due to its high nutritional value and growth rate. Obtaining their genetic information is essential for their sustainable capture-based production. In the present study, genetic variation, population structure, and demographic processes of the populations across the distribution of this species were assessed using the mitochondrial DNA ATPase6 and cytb gene. In total, we selected 170 samples from five localities across the Indian subcontinent including Andaman Sea. Sequence analysis of partial cytb (885 bp) and ATPase6 (714 bp) genes revealed 45 and 58 haplotypes, respectively. The significant coefficient of genetic differentiation (FST: 0.255 for cytb and 0.252 for ATPase6) and analyses of molecular variance indicated three varieties of stocks, namely Arabian Sea, Bay of Bengal, and Andaman Sea. All the populations showed low nucleotide diversity, suggesting severe historical bottleneck events and high haplotype diversity, indicating population expansion. The genetic variation and demographic process reported in this study will form the baseline information for framing policies, which can be adopted while planning stock specific ranching and relaying programmes in the Indian subcontinent with view to enhance and manage the fishery.