V2-Net: An Attention-guided Volumetric Regression Network for Tooth Landmark Localization on CT Images with Metal Artifacts.

For virtual surgical planning in orthognathic surgery, marking tooth landmarks on CT images is an important procedure. However, the manual localization procedure of tooth landmarks is time-consuming, labor-intensive, and requires expert knowledge. Also, direct and automatic tooth landmark localization on CT images is difficult because of the lower resolution and metal artifacts of dental images. The purpose of this study was to propose an attention-guided volumetric regression network (V2-Net) for accurate tooth landmark localization on CT images with metal artifacts and lower resolution. V2-Net has an attention-guided network architecture using a coarse-to-fine-attention mechanism that guided the 3D probability distribution of tooth landmark locations within anatomical structures from the coarse V-Net to the fine V-Net for more focus on tooth landmarks. In addition, we combined attention-guided learning and a 3D attention module with optimal Pseudo Huber loss to improve the localization accuracy. Our results show that the proposed method achieves state-of-the-art accuracy of 0.85 ± 0.40 mm in terms of mean radial error, outperforming previous studies. In ablation studies, we observed that the proposed attention-guided learning and a 3D attention module improved the accuracy of tooth landmark localization in CT images of lower resolution and metal artifacts. Furthermore, our method achieved 97.92% in terms of the success detection rate within the clinically accepted accuracy range of 2.0 mm.

Chromosome-level genome assembly of the shuttles hoppfish, Periophthalmus modestus.

BACKGROUND: The shuttles hoppfish (mudskipper), Periophthalmus modestus, is one of the mudskippers, which are the largest group of amphibious teleost fishes, which are uniquely adapted to live on mudflats. Because mudskippers can survive on land for extended periods by breathing through their skin and through the lining of the mouth and throat, they were evaluated as a model for the evolutionary sea-land transition of Devonian protoamphibians, ancestors of all present tetrapods. RESULTS: A total of 39.6, 80.2, 52.9, and 33.3 Gb of Illumina, Pacific Biosciences, 10X linked, and Hi-C data, respectively, was assembled into 1,419 scaffolds with an N50 length of 33 Mb and BUSCO score of 96.6%. The assembly covered 117% of the estimated genome size (729 Mb) and included 23 pseudo-chromosomes anchored by a Hi-C contact map, which corresponded to the top 23 longest scaffolds above 20 Mb and close to the estimated one. Of the genome, 43.8% were various repetitive elements such as DNAs, tandem repeats, long interspersed nuclear elements, and simple repeats. Ab initio and homology-based gene prediction identified 30,505 genes, of which 94% had homology to the 14 Actinopterygii transcriptomes and 89% and 85% to Pfam familes and InterPro domains, respectively. Comparative genomics with 15 Actinopterygii species identified 59,448 gene families of which 12% were only in P. modestus. CONCLUSIONS: We present the high quality of the first genome assembly and gene annotation of the shuttles hoppfish. It will provide a valuable resource for further studies on sea-land transition, bimodal respiration, nitrogen excretion, osmoregulation, thermoregulation, vision, and mechanoreception.

A Complete Digital Workflow for Planning, Simulation, and Evaluation in Orthognathic Surgery.

The purpose of this study was to develop a complete digital workflow for planning, simulation, and evaluation for orthognathic surgery based on 3D digital natural head position reproduction, a cloud-based collaboration platform, and 3D landmark-based evaluation. We included 24 patients who underwent bimaxillary orthognathic surgery. Surgeons and engineers could share the massive image data immediately and conveniently and collaborate closely in surgical planning and simulation using a cloud-based platform. The digital surgical splint could be optimized for a specific patient before or after the physical fabrication of 3D printing splints through close collaboration. The surgical accuracy was evaluated comprehensively via the translational (linear) and rotational (angular) discrepancies between identical 3D landmarks on the simulation and postoperative computed tomography (CT) models. The means of the absolute linear discrepancy at eight tooth landmarks were 0.61 ± 0.55, 0.86 ± 0.68, and 1.00 ± 0.79 mm in left-right, advance-setback, and impaction-elongation directions, respectively, and 1.67 mm in the root mean square direction. The linear discrepancy in the left-right direction was significantly different from the other two directions as shown by analysis of variance (ANOVA, p < 0.05). The means of the absolute angular discrepancies were 1.43 ± 1.06°, 0.50 ± 0.31°, and 0.58 ± 0.41° in the pitch, roll, and yaw orientations, respectively. The angular discrepancy in the pitch orientation was significantly different from the other two orientations (ANOVA, p < 0.05). The complete digital workflow that we developed for orthognathic patients provides efficient and streamlined procedures for orthognathic surgery and shows high surgical accuracy with efficient image data sharing and close collaboration.

First draft genome for the sand-hopper Trinorchestia longiramus.

Crustacean amphipods are important trophic links between primary producers and higher consumers. Although most amphipods occur in or around aquatic environments, the family Talitridae is the only family found in terrestrial and semi-terrestrial habitats. The sand-hopper Trinorchestia longiramus is a talitrid species often found in the sandy beaches of South Korea. In this study, we present the first draft genome assembly and annotation of this species. We generated ~380.3 Gb of sequencing data assembled in a 0.89 Gb draft genome. Annotation analysis estimated 26,080 protein-coding genes, with 89.9% genome completeness. Comparison with other amphipods showed that T. longiramus has 327 unique orthologous gene clusters, many of which are expanded gene families responsible for cellular transport of toxic substances, homeostatic processes, and ionic and osmotic stress tolerance. This first talitrid genome will be useful for further understanding the mechanisms of adaptation in terrestrial environments, the effects of heavy metal toxicity, as well as for studies of comparative genomic variation across amphipods.

Microbubble-Triggered Spontaneous Separation of Transparent Thin Films from Substrates Using Evaporable Core-Shell Nanocapsules.

The spontaneous separation of a polymer thin film from a substrate is an innovative technology that will enable material recycling and reduce manufacturing cost in the film industry, and this can be applied in a wide range of applications, from optical films to wearable devices. Here, we present an unprecedented spontaneous strategy for separating transparent polymer films from substrates on the basis of microbubble generation using nanocapsules containing an evaporable material. The core-shell nanocapsules are prepared from poly(methyl methacrylate)-polyethyleneimine nanoparticles via the encapsulation of methylcyclohexane (MCH). A spherical nanostructure with a vaporizable core is obtained, with the heat-triggered gas release ability leading to the formation of microbubbles. Our separation method applied to transparent polymer films doped with a small amount of the nanocapsules encapsulating evaporable MCH enables spontaneous detachment of thin films from substrates via vacuum-assisted rapid vaporization of MCH over a short separation time, and clear detachment of the film is achieved with no deterioration of the inherent optical transparency and adhesive property compared to a pristine film.

Fabrication of Vertically Aligned Liquid Crystals Devices Using Nanoscale Self-Assembled Alignment Layers of Photoluminescent Pyrene Derivatives.

Nanoscale self-assembled molecular layers of 1-pyrene carboxylic acid, 1-pyrene butylic acid, and 1-amino pyrene were employed as photoluminescent alignment agents to form vertical arrays of liquid crystals (LCs). The LC device using alignment agent of 1-amino pyrene appeared to have a stable vertical alignment based on crossed polarization analysis. The electro-optical properties of the LCs fabricated using this self-assembled layer exhibited better performance than those of general LC cells containing a conventional polyimide layer. The proposed self-assembled alignment method is sufficient as a replacement for more commonly used polyimide layers, which require complex film forming processing and high production costs; conversely, the proposed technique allows for simple mixing using low concentrations of alignment agents (0.05 wt%). Moreover, as LCs were mixed with the pyrene derivatives, photoluminescence (PL) under ultraviolet (UV) light was exhibited. This proposed method has excellent LC alignment and PL property, both of which can be utilized in advanced display technologies for next-generation LC devices, such as polyimide-free alignment or color-filter-free color expression.

Autonomous bone reposition around anatomical landmark for robot-assisted orthognathic surgery.

The purpose of this study was to develop a new method for enabling a robot to assist a surgeon in repositioning a bone segment to accurately transfer a preoperative virtual plan into the intraoperative phase in orthognathic surgery. We developed a robot system consisting of an arm with six degrees of freedom, a robot motion-controller, and a PC. An end-effector at the end of the robot arm transferred the movements of the robot arm to the patient's jawbone. The registration between the robot and CT image spaces was performed completely preoperatively, and the intraoperative registration could be finished using only position changes of the tracking tools at the robot end-effector and the patient's splint. The phantom's maxillomandibular complex (MMC) connected to the robot's end-effector was repositioned autonomously by the robot movements around an anatomical landmark of interest based on the tool center point (TCP) principle. The robot repositioned the MMC around the TCP of the incisor of the maxilla and the pogonion of the mandible following plans for real orthognathic patients. The accuracy of the robot's repositioning increased when an anatomical landmark for the TCP was close to the registration fiducials. In spite of this influence, we could increase the repositioning accuracy at the landmark by using the landmark itself as the TCP. With its ability to incorporate virtual planning using a CT image and autonomously execute the plan around an anatomical landmark of interest, the robot could help surgeons reposition bones more accurately and dexterously.

Correlations between anatomic variations of maxillary sinus ostium and postoperative complication after sinus lifting.

OBJECTIVES: The maxillary sinus mucosa is reported to recover to preoperative sterility after sinus floor elevation. However, when drainage of maxillary sinus is impaired, recovery can be delayed and maxillary sinusitis can occur. Therefore, in this study, we investigated the correlations between anatomic variants that can interrupt the ostium of the maxillary sinus and incidence of complication after sinus lifting. MATERIALS AND METHODS: The subjects are 81 patients who underwent sinus lifting in Wonkwang University Dental Hospital (Iksan, Korea). Computed tomography (CT) images of the subjects were reviewed for presence of nasal septum deviation, anatomic variants of the middle turbinate, and Haller cells. Correlations between anatomic variations and occurrence of maxillary sinusitis were statistically analyzed. RESULTS: Patients with anatomic variants of ostio-meatal units, such as deviated nasal septum, concha bullosa or paradoxical curvature of the middle turbinate, or Haller cells, showed a higher rate of complication. However, only presence of Haller cell showed statistically significant. CONCLUSION: Before sinus lifting, CT images are recommended to detect anatomic variants of the ostio-meatal complex. If disadvantageous anatomic variants are detected, the use of nasal decongestants should be considered to reduce the risk of postoperative sinusitis.

Advantages of intraoral and transconjunctival approaches for posterior displacement of a fractured zygomaticomaxillary complex.

BACKGROUND: Fracture of the zygomaticomaxillary complex (ZMC) is one of the most common facial injuries. A previous study has performed 3D analyses of the parallel and rotational displacements that occur in a fractured ZMC. However, few studies have investigated adequate fixation methods according to these displacements. Here, we assessed whether specific approaches and fixation methods for displacement of ZMC fractures produce esthetic results. METHODS: Hospital records and pre- and post-surgical computed tomographic scans of patients treated for ZMC fractures at the Department of Oral and Maxillofacial Surgery, College of Dentistry, Wonkwang University, between January 2010 and December 2015, were selected. Data were analyzed according to the direction of displacement and post-reduction prognosis using a 3D software. RESULTS: With ZMC fractures, displacement in the posterior direction occurred most frequently, while displacement in the superior-inferior direction was rare. A reduction using a transconjunctival approach and an intraoral approach was statistically better than that using an intraoral approach, Gillies approach, and lateral canthotomy approach for a posterior displacement (P < 0.05). CONCLUSIONS: When posterior displacement of a fractured ZMC occurs, use of an intraoral approach and transconjunctival approach simultaneously is recommended for reducing and fixing the displaced fragment accurately.

Changes of lip morphology following mandibular setback surgery using 3D cone-beam computed tomography images.

BACKGROUND: The aims of this study are to evaluate the lip morphology and change of lip commissure after mandibular setback surgery (MSS) for class III patients and analyze association between the amount of mandibular setback and change of lip morphology. METHODS: The samples consisted of 14 class III patients treated with MSS using bilateral sagittal split ramus osteotomy. Lateral cephalogram and cone-beam CT were taken before and about 6 months after MSS. Changes in landmarks and variables were measured with 3D software program Ondemand™. Paired and independent t tests were performed for statistical analysis. RESULTS: Landmarks in the mouth corner (cheilion, Ch) moved backward and downward (p < .005, p < .01). However, cheilion width was not statistically significantly changed. Landmark in labrale superius (Ls) was not altered significantly. Upper lip prominence angle (ChRt-Ls-ChLt °) became acute. Landmarks in stomion (Stm), labrale inferius (Li) moved backward (p < .005, p < .001). Lower lip prominence angle (ChRt-Li-ChLt °) became obtuse (p < .001). Height of the upper and lower lips was not altered significantly. Length of the upper lip vermilion was increased (p =< 0.01), and length of the lower lip vermilion was decreased (p < .05). Lip area on frontal view was not statistically significantly changed, but the upper lip area on lateral view was increased and change of the lower lip area decreased (p > .05, p < .005). On lateral view, upper lip prominent point (UP) moved downward and stomion moved backward and upward and the angle of Ls-UP-Stm (°) was decreased. Lower lip prominent point (LP) moved backward and downward, and the angle of Stm-LP-Li (°) was increased. Li moved backward. Finally, landmarks in the lower incisor tip (L1) moved backward and upward, but stomion moved downward. After surgery, lower incisor tip (L1) was positioned more superiorly than stomion (p < .05). There were significant associations between horizontal soft tissue and corresponding hard tissue. The posterior movement of L1 was related to statistically significantly about backward and downward movement of cheilion. CONCLUSIONS: The lip morphology of patients with dento-skeletal class III malocclusion shows a significant improvement after orthognathic surgery. Three-dimensional lip morphology changes in class III patients after MSS exhibited that cheilion moved backward and downward, upper lip projection angle became acute, lower lip projection angle became obtuse, change of upper lip area on lateral view was increased, change of lower lip area decreased, and morphology of lower lip was protruding. L1 was concerned with the lip tissue change in statistically significant way.