Comparison of near-infrared imaging with cone-beam computed tomography for proximal caries detection in permanent dentition: An in vivo study.

OBJECTIVES: This study aimed to evaluate the diagnostic performance of near-infrared imaging (NIRI) and unaided visual examination (UVE) in detecting proximal caries in permanent dentition in comparison with cone-beam computed tomography (CBCT). METHODS: Patients who underwent NIRI, UVE, and CBCT imaging within 1 week were enrolled. Using CBCT as the reference test, the positive percent agreement (PPA), negative percent agreement (NPA), and overall percent agreement (OPA) of NIRI, UVE, and a combination of the two for detecting proximal caries at different depths and in different tooth locations were assessed. Additionally, the consistency of these diagnostic methods with CBCT was evaluated. RESULTS: We evaluated 6,084 proximal surfaces and identified 177 CBCT-positive sites. NIRI had a PPA, NPA, and OPA of 68.93%, 99.09%, and 98.21%, respectively, with a substantial agreement with CBCT. When combined with UVE, the PPA increased by approximately 50% compared with that of UVE alone. Regarding caries at different depths, NIRI outperformed UVE in detecting initial caries (ICDAS 1-2) over moderate-to-advanced caries (ICDAS 3-6). However, the combined use of NIRI and UVE improved the detection of moderate-to-advanced caries. In the anterior teeth region, NIRI exhibited excellent agreement with CBCT, surpassing its performance in the posterior region. CONCLUSIONS: Although NIRI cannot fully replace radiographic methods, the substantial agreement of NIRI with CBCT in detecting proximal caries highlights its potential as a complementary tool in routine caries screening, especially when combined with UVE. CLINICAL SIGNIFICANCE: This study highlights the potential of NIRI as a radiation-free method for detecting proximal caries in permanent teeth. Early detection through regular NIRI scanning can lead to timely intervention, improved patient outcomes, and reduced overall disease burden.

The radiomics nomogram predicts the prognosis of pancreatic cancer patients with hepatic metastasis after chemoimmunotherapy.

OBJECTIVE: To construct a prognostic model based on MR features and clinical data to evaluate the progression free survival (PFS), overall survival (OS) and objective response rate (ORR) of pancreatic cancer patients with hepatic metastases who received chemoimmunotherapy. METHODS: 105 pancreatic cancer patients with hepatic metastases who received chemoimmunotherapy were assigned to the training set (n = 52), validation set (n = 22), and testing set (n = 31). Multi-lesion volume of interest were delineated, multi-sequence radiomics features were extracted, and the radiomics models for predicting PFS, OS and ORR were constructed, respectively. Clinical variables were extracted, and the clinical models for predicting PFS, OS and ORR were constructed, respectively. The nomogram was jointly constructed by radiomics model and clinical model. RESULT: The ORR exhibits no significant correlation with either PFS or OS. The area under the curve (AUC) of nomogram for predicting 6-month PFS reached 0.847 (0.737-0.957), 0.786 (0.566-1.000) and 0.864 (0.735-0.994) in the training set, validation set and testing set, respectively. The AUC of nomogram for predicting 1-year OS reached 0.770 (0.635-0.906), 0.743 (0.479-1.000) and 0.818 (0.630-1.000), respectively. The AUC of nomogram for predicting ORR reached 0.914 (0.828-1.00), 0.938 (0.840-1.00) and 0.846 (0.689-1.00), respectively. CONCLUSION: The prognostic models based on MR imaging features and clinical data are effective in predicting the PFS, OS and ORR of chemoimmunotherapy in pancreatic cancer patients with hepatic metastasis, and can be used to evaluate the prognosis of patients.

Longitudinal characteristics of physical frailty and its components in men and women post hip fracture.

BACKGROUND: Frailty is an important geriatric syndrome predicting adverse health outcomes in older adults. However, the longitudinal characteristics of frailty components in post-hip fracture patients are less understood. Adopting the Fried frailty definition, we examined the longitudinal trends and sex trajectory differences in frailty and its components over 1 year post-fracture. METHODS: Three hundred and twenty-seven hip fracture patients (162 men and 165 women with mean age 80.1 and 81.5) from Baltimore Hip Studies 7th cohort with measurements at 22 days after admission, and months 2, 6, and 12 post-fracture were analyzed. Frailty components included: grip strength, gait speed, weight, total energy expenditure, and exhaustion. Longitudinal analysis used mixed effect models. RESULTS: At baseline, men were sicker with worse cognitive status, and had higher weight and grip strength, but lower total energy expenditure than women (p < 0.001). The prevalence of frailty was 31.5%, 30.2%, and 28.2% at months 2, 6, and 12 respectively, showing no longitudinal trends or sex differences. However, its components showed substantial recovery trends over the post-fracture year after confounding adjustments, including increasing gait speed, reducing risk of exhaustion, and stabilized weight loss and energy expenditure over time. Particularly, while men's grip strength tended to remain stable over first year post surgery within patients, women's grip strength reduced significantly over time within patients. On average over time within patients, women were more active with higher energy expenditures but lower grip strength and weight than men. CONCLUSION: Significant recovery trends and sex differences were observed in frailty components during first year post-fracture. Overall frailty status did not show those trends over months 2-12 since a summary measure might obscure changes in components. Therefore, frailty components provided important multi-dimensional information on the complex recovery process of patients, indicating targets for intervention beyond the global binary measure of frailty.

Biomass smoke exposure and somatic growth among children: The RESPIRE and CRECER prospective cohort studies in rural Guatemala.

BACKGROUND: Cooking-related biomass smoke is a major source of household air pollution (HAP) and an important health hazard. Prior studies identified associations between HAP exposure and childhood stunting; less is known for underweight and wasting. Few studies had personal HAP measurements. METHODS: 557 households in rural Guatemala were enrolled in the CRECER study, the follow-up study of the RESPIRE randomized intervention trial. They were assigned to three groups that received chimney stoves at different ages of the study children. Multiple personal carbon monoxide (CO) exposure measurements were used as proxies for HAP exposures. Children's heights and weights were measured from 24 to 60 months of age. Height-for-age z-score (HAZ), weight-for-age z-score (WAZ), and weight-for-height z-score (WHZ) were calculated based on the World Health Organization's Multicentre Growth Reference Study. HAZ, WAZ, and WHZ below -2 were classified as stunting, underweight, and wasting, respectively. Generalized linear models and mixed effects models were applied. RESULTS: 541 children had valid anthropometric data, among whom 488 (90.2 %) were stunted, 192 (35.5 %) were underweight, and 2 (0.3 %) were wasted. A 1 ppm higher average CO exposure was associated with a 0.21 lower HAZ (95 % CI: 0.17-0.25), a 0.13 lower WAZ (95 % CI: 0.10-0.17) and a 0.06 lower WHZ (95 % CI: 0.02-0.10).The associations for HAZ were stronger among boys (coefficient = -0.29, 95 % CI: -0.35 - -0.22) than among girls (coefficient = -0.15, 95 % CI: -0.20 - -0.10). A 1 ppm-year higher cumulative CO exposure was associated with a higher risk of moderate stunting among boys (OR = 1.27, 95 % CI: 1.05-1.59), but not among girls. DISCUSSION: In this rural Guatemalan population, higher HAP exposure was associated with lower HAZ and WAZ. The associations between HAP and HAZ/stunting were stronger among boys. Reducing HAP might benefit childhood somatic growth in rural populations of low-income countries.

Enhancement of wide-band trace terahertz absorption spectroscopy based on microstructures: a review.

Research on the interaction between nanoscale materials and light holds significant scientific significance for the development of fields such as optoelectronic conversion and biosensing. The study of micro- and nano-optics has produced numerous outstanding research achievements by utilizing the dielectric optical coupling mechanism and plasmon effects to enhance the interaction between light and matter. These findings have demonstrated tremendous potential for applications in the field of molecular fingerprint sensing. This review focuses on a retrospective analysis of recent research studies in the enhancement of wide-band trace terahertz absorption spectroscopy. The physical mechanisms of using waveguide structures, dielectric metasurfaces/meta-gratings, and spoof surface plasmon polaritons (SSPs) to improve the interaction between light and trace-amount matters are introduced. The new approaches and methods for enhancing broad-band terahertz absorption spectroscopy of trace samples using microstructure designs are discussed. Additionally, we elucidate the scientific ideas and exploratory achievements in enhancing terahertz fingerprint spectroscopy detection. Finally, we provide an outlook on the research and development direction and potential practical applications of absorption spectroscopy enhancement detection.

Effects of nano metal oxide particles on denitrifying phosphorus removal system: Potential stress mechanism and recovery strategy.

The accumulation of nano metal oxide particles (NMOPs) in municipal sewage treatment systems harms the microbial community and its metabolism in activated sludge system, resulting in the degradation of its pollutants removal performance. In this work, the stress effect of NMOPs on the denitrifying phosphorus removal system was systematically investigated in terms of pollutants removal performance, key enzyme activities, microbial community diversity and abundances, and intracellular metabolites. Among the ZnO NPs, TiO2 NPs, CeO2 NPs, and CuO NPs, the ZnO NPs showed the most significant impacts with the chemical oxygen demand, total phosphorus, and nitrate nitrogen removal ratio decreased from above 90 % to 66.50 %, 49.13 %, and 57.11 %, respectively. The addition of surfactants and chelating agents could relieve the toxic effect of NMOPs on the denitrifying phosphorus removal system, and the chelating agents were more effective than surfactants in performance recovery. After adding ethylene diamine tetra acetic acid, the removal ratio of chemical oxygen demand, total phosphorus, and nitrate nitrogen under ZnO NPs stress was restored to 87.31 %, 88.79 %, and 90.35 %, respectively. The study provides valuable knowledge to better understand the impacts and stress mechanism of NMOPs on activated sludge systems and provides a solution to recover the nutrients removal performance of denitrifying phosphorus removal system under NMOPs stress.

Finite element analysis of the biomechanical effect of clear aligners in extraction space closure under different anchorage controls.

INTRODUCTION: Clear aligners (CAs) have attracted increasing attention from patients and orthodontists because of their excellent esthetics and comfort. However, treating tooth extraction patients with CAs is difficult because their biomechanical effects are more complicated than those of traditional appliances. This study aimed to analyze the biomechanical effect of CAs in extraction space closure under different anchorage controls, including moderate, direct strong, and indirect strong anchorage. It could provide several new cognitions for anchorage control with CAs through finite element analysis, further directing clinical practice. METHODS: A 3-dimensional maxillary model was generated by combining cone-beam computed tomography and intraoral scan data. Three-dimensional modeling software was used to construct a standard first premolar extraction model, temporary anchorage devices, and CAs. Subsequently, finite element analysis was performed to simulate space closure under different anchorage controls. RESULTS: Direct strong anchorage was beneficial for reducing the clockwise occlusal plane rotation, whereas indirect anchorage was conducive for anterior teeth inclination control. In the direct strong anchorage group, an increase in the retraction force would require more specific anterior teeth overcorrection to resist the tipping movement, mainly including lingual root control of the central incisor, followed by distal root control of the canine, lingual root control of the lateral incisor, distal root control of the lateral incisor, and distal root control of the central incisor. However, the retraction force could not eliminate the mesial movement of the posterior teeth, possibly causing a reciprocating motion during treatment. In indirect strong groups, when the button was close to the center of the crown, the second premolar presented less mesial and buccal tipping but more intrusion. CONCLUSIONS: The 3 anchorage groups showed significantly different biomechanical effects in both the anterior and posterior teeth. Specific overcorrection or compensation forces should be considered when using different anchorage types. The moderate and indirect strong anchorages have a more stable and single-force system and could be reliable models in investigating the precise control of future tooth extraction patients.

Biomass Smoke Exposure and Atopy among Young Children in the Western Highlands of Guatemala: A Prospective Cohort Study.

Women and children in rural regions of low-income countries are exposed to high levels of household air pollution (HAP) as they traditionally tend to household chores such as cooking with biomass fuels. Early life exposure to air pollution is associated with aeroallergen sensitization and developing allergic diseases at older ages. This prospective cohort study assigned HAP-reducing chimney stoves to 557 households in rural Guatemala at different ages of the study children. The children's air pollution exposure was measured using personal CO diffusion tubes. Allergic outcomes at 4-5 years old were assessed using skin prick tests and International Study of Asthma and Allergies in Childhood (ISAAC)-based questionnaires. Children assigned to improved stoves before 6 months old had the lowest HAP exposure compared to the other groups. Longer exposure to the unimproved stoves was associated with higher risks of maternal-reported allergic asthma (OR = 2.42, 95% CI: 1.11-5.48) and rhinitis symptoms (OR = 2.01, 95% CI: 1.13-3.58). No significant association was found for sensitization to common allergens such as dust mites and cockroaches based on skin prick tests. Reducing HAP by improving biomass burning conditions might be beneficial in preventing allergic diseases among children in rural low-income populations.

The preparation of lactoferrin/magnesium silicate lithium injectable hydrogel and application in promoting wound healing.

The development of novel wound dressings with highly effective antibacterial and accelerating wound healing properties has become the focus of current research. In this study, a novel and injectable lactoferrin (LF)/lithium magnesium silicate hydrogel (LMSH) was first synthesized through a simple electrostatic interaction method. The physical and biological properties are systematically characterized. The results show that the synthesized LF/LMSH has good antibacterial properties and biocompatibility. More importantly, it can effectively promote wound healing in the rat full-thickness skin wound model after 14 days post-operation, and the healing rate can reach 99.1 %, which is much higher than that of other groups. Meanwhile, histochemical and immunofluorescent staining confirm that the prepared injectable LF/LMSH has good pro-collagen deposition, pro-angiogenic and anti-inflammatory properties. The healed wounds present a consistently thickened epidermis with more follicular and glandular structures, indicating the great potential of the prepared material for wound management.

Cobalt-Catalyzed Regio-, Diastereo- and Enantioselective Intermolecular Hydrosilylation of 1,3-Dienes with Prochiral Silanes.

One of the most straightforward approaches to access chiral silanes is catalytic enantioselective hydrosilylation. Although significant advances have been achieved in enantioselective construction of either a carbon-stereogenic center or a silicon-stereogenic center through enantioselective hydrosilylation, simultaneous establishment of a carbon- and a silicon-stereogenic center in an acyclic molecule through a single intermolecular hydrosilylation remained undeveloped. Herein, an unprecedented cobalt-catalyzed regio-, diastereo- and enantioselective hydrosilylation of 1,3-dienes is presented, enabling construction of a carbon- and a silicon-stereogenic center in a single intermolecular transformation. A wide range of chiral silanes bearing a carbon- and a silicon-stereogenic center were generated in high efficiency and stereoselectivity. Functionalization of the enantioenriched silanes delivered a variety of valuable chiral building blocks that are otherwise difficult to access.

Precise construction of lithiophilic sites by diyne-linked phthalocyanine polymer for suppressing metallic lithium dendrite.

Uncontrolled growth of lithium dendrite is the key challenge that impedes the practical application of Li anodes in high-energy-density Li-metal batteries. Precisely constructing lithiophilic active sites on the anode surface is expected to be an effective strategy for promoting the anode interfacial properties and alleviating the dendrite growth of lithium. Herein, a diyne-linked phthalocyanine polymer (PcEP) with precise lithiophilic active sites is designed and constructed in a bottom-up manner in situ on the surface of the copper foil via the coupling reaction of tetraethynylphthalocyanine. The lithiophilic electron-rich pyrrolic nitrogen and aza nitrogen in the Pc structure, and the sp-hybridized carbon in the diyne linkage (-CC-CC-) in PcEP can conduct the homogeneous nucleation and deposition processes of lithium, and thus suppress the dendrite growth. This dendrite-free metallic lithium anode exhibits reduced overpotential, high coulombic efficiency (98.6%), and prolonged lifespan (200% longer than that of a Cu anode). These impressive achievements demonstrate that the advanced phthalocyanine polymer might be a promising material for addressing the critical interfacial issues related to the next-generation high-energy-density Li-metal-based storage devices.

Cobalt-Catalyzed Sequential Site- and Stereoselective Hydrosilylation of 1,3- and 1,4-Enynes.

Catalytic sequential hydrosilylation of 1,3-enynes and 1,4-enynes promoted by cobalt complexes derived from bisphosphines are presented. Site- and stereoselective Si-H addition of primary silanes to 1,3-enynes followed by sequential intramolecular diastereo- and enantioselective Si-H addition afforded enantioenriched cyclic alkenylsilanes with simultaneous construction of a carbon-stereogenic center and a silicon-stereogenic center. Reactions of 1,4-enynes proceeded through sequential isomerization of the alkene moiety followed by site- and stereoselective hydrosilylation. A wide range of alkenylsilanes were afforded in high efficiency and selectivity. Functionalization of the enantioenriched silanes containing a stereogenic center at silicon delivered a variety of chiral building blocks that are otherwise difficult to access.

Potential nanotherapeutic strategies for perioperative stroke.

AIMS: Based on the complex pathological environment of perioperative stroke, the development of targeted therapeutic strategies is important to control the development of perioperative stroke. DISCUSSIONS: Recently, great progress has been made in nanotechnology, and nanodrug delivery systems have been developed for the treatment of ischemic stroke. CONCLUSION: In this review, the pathological processes and mechanisms of ischemic stroke during perioperative stroke onset were systematically sorted. As a potential treatment strategy for perioperative stroke, the review also summarizes the multifunctional nanodelivery systems based on ischemic stroke, thus providing insight into the nanotherapeutic strategies for perioperative stroke.

Lead contamination of public drinking water and academic achievements among children in Massachusetts: a panel study.

BACKGROUND: Public drinking water can be an important source exposure to lead, which can affect children's cognitive development and academic performance. Few studies have looked at the impact of lead exposures from community water supplies or their impact on school achievements. We examined the association between annual community water lead levels (WLLs) and children's academic performances at the school district level. METHODS: We matched the 90th percentile WLLs with the grade 3-8 standardized test scores from the Stanford Education Data Archive on Geographic School Districts by geographic location and year. We used multivariate linear regression and adjusted for urbanicity, race, socioeconomic characteristics, school district, grade, and year. We also explored potential effect measure modifications and lag effects. RESULTS: After adjusting for potential confounders, a 5 µg/L increase in 90th percentile WLLs in a GSD was associated with a 0.00684 [0.00021, 0.01348] standard deviation decrease in the average math test score in the same year. No association was found for English Language Arts. CONCLUSIONS: We found an association between the annual fluctuation of WLLs and math test scores in Massachusetts school districts, after adjusting for confounding by urbanicity, race, socioeconomic factors, school district, grade, and year. The implications of a detectable effect of WLLs on academic performance even at the modest levels evident in MA are significant and timely. Persistent efforts should be made to further reduce lead in drinking water.

Ambient air pollution associated with lower academic achievement among US children: A nationwide panel study of school districts.

BACKGROUND: Ambient air pollution is an important environmental exposure and has been linked with impaired cognitive function. Few studies have investigated its impact on children's academic performance on a nationwide level. We hypothesize that higher ambient air pollution concentrations will be associated with lower average academic test scores. METHODS: We investigated three prevalent ambient air pollutants: PM2.5, NO2 and ozone, and their associations with the average academic test scores, at the Geographic School District (GSD) level, of the third to eighth grade students in the United States from 2010 to 2016. We applied multivariate linear regression and controlled for urbanicity, socioeconomic status, student racial/ethnic compositions, and individual intercepts for each district-grade level and each year. RESULTS: We found that an interquartile range increase in PM2.5 concentrations was associated with a 0.007 (95% confidence interval: 0.005, 0.009) SD lower average math test scores, and a 0.004 (95% confidence interval: 0.002, 0.005) SD lower average English language/arts test scores. Similar associations were observed for NO2 and ozone on math, and for NO2 on English language/arts. The magnitudes of these associations are equivalent to the effects of short-term reductions of thousands of dollars in district median household income. The reductions in test scores were larger for GSDs with higher socioeconomic status, though most associations remained negative at all socioeconomic levels. CONCLUSIONS: Our results show that ambient air pollution within a GSD is associated with lower academic performance among children. Further improving air quality may benefit children's overall academic achievement and socioeconomic attainment across the lifespan.

Minimally-invasive-perventricular-device-occlusion versus surgical-closure for treating perimembranous-ventricular-septal-defect: 3-year outcomes of a multicenter randomized clinical trial.

BACKGROUND: Minimally-invasive-perventricular-device-occlusion (MIPDO) combined superiority of surgical-repair and percutaneous-device-closure in treating perimembranous-ventricular-septal-defect (pmVSD). This study was to evaluate the efficacy and safety of MIPDO for treating pmVSD, comparing with surgical-repair. METHODS: Patients aged ≥3 months with isolated pmVSDs were randomized to undergo either surgical or MIPDO procedure, with the median follow-up time of 49 months. The primary outcome was the rate of complete pmVSD closure at discharge. The secondary outcomes included the adverse events during hospitalization and follow-up, chest tube output volume, blood transfusion volume, procedural duration, ventilation time, hospitalization duration and hospitalization cost. Also, perioperative cardiac performance and systemic conditions were evaluated. RESULTS: Of the 313 patients (9 months to 42 years old; median, 4 years old) with pmVSDs recruited from 3 centers, 100 were finally enrolled and randomly allocated 1:1 into two groups. The non-inferiority (non-inferiority margin -8.0%) of MIPDO to surgical closure regarding efficacy was shown in both intention-to-treat (0, 95% CI: -0.055 to 0.055) and per-protocol populations (0.02, 95% CI: -0.018 to 0.058). Although the rate of adverse events was similar between groups, the MIPDO group showed superiority in procedural duration, ventilation time, chest tube output volume, postoperative hospitalization time and hospitalization cost compared with surgical group (P<0.05). Moreover, MIPDO method showed comparable perioperative cardiac performance with milder change of systemic condition. CONCLUSIONS: In patients with pmVSDs, MIPDO method showed non-inferiority to surgical closure in efficacy for both intention-to-treat and per-protocol population with easier perioperative recovery, economic benefit and promising outcomes.

PTH/PTHrP in controlled release hydrogel enhances orthodontic tooth movement by regulating periodontal bone remodaling.

OBJECTIVE: This study aimed to evaluate the effects of local application of parathyroid hormone (PTH) or parathyroid hormone-related protein (PTHrP) on osteogenesis and osteoclastogenesis during orthodontic tooth movement (OTM). BACKGROUND: Periodontal bone remodeling is the crucial biological process in the OTM that involves both bone resorption and formation, with the former more important as the initiator. PTH or PTHrP both play dual roles in bone remodeling regulation, and the balance may shift to the bone resorption side when they are given continuously, suggesting them as potential candidate medicine for OTM acceleration. METHODS: A total of 40 rats underwent orthodontic mesialization of the maxillary first molars and received no micro-perforation (MOP), or MOP followed by injection of temperature-sensitive hydrogel containing PTH, PTHrP, or normal saline. The rats were sacrificed after 2-week OTM, except for the relapse groups, which had one more week of observation after removal of the force appliances. The amount of tooth movement, rate of relapse after OTM, and effects on the bone remodeling were assessed through micro-computed tomography (µCT) analysis, alkaline phosphatase (ALP) assay, alizarin red staining, tartrate-resistant acid phosphatase (TRAP) staining, immunohistochemistry (IHC) analysis, Western blot (WB), and quantitative real-time polymerase chain reaction (qRT-PCR). The effects of PTHrP on the osteogenic differentiation of human periodontal ligament cells (hPDLCs) were explored in vitro. RESULTS: The cumulative release of PTH or PTHrP from PECE hydrogels was beyond 75% at 14 days in a sustained manner. After the intervention in vivo, the distance of OTM in the PTH (0.78 ± 0.06 mm) or PTHrP (0.81 ± 0.04 mm) group was significantly larger than that of the MOP only (0.51 ± 0.04 mm) or the no MOP (0.46 ± 0.05 mm) group. Moreover, PTH injection significantly reduced the rate of relapse after OTM (25.7 ± 4.3%) compared to the control (69.6 ± 6.1%). µCT analysis showed decreased BV/TV, BS/BV, and Tb.N, while increased Tb.Sp of alveolar bone in the PTH or PTHrP group. There were also more TRAP-positive osteoclasts in the PTH or PTHrP group with a significantly enhanced ratio of receptor activator of nuclear factor-κB ligand (RANKL)/osteoprotegerin (OPG). The protein expressions of PTH/PTHrP type 1 receptor (PTHR1), alkaline phosphatase (ALP), osteocalcin (OCN), runt-related transcription factor 2 (RUNX2), and ß-catenin were significantly increased in the PTH or PTHrP group, as well as the gene expressions of Pth1r, Bglap, and Alpl. There was no significant difference between the effects of PTH and PTHrP. Nevertheless, inhibition of PTHrP on the osteogenic differentiation of hPDLCs was detected in vitro with decreased expression of OCN, RUNX2, COL-1, and ALP. CONCLUSION: Local injection of either PTH or PTHrP carried by controlled release PECE hydrogel similarly enhances OTM in rats through regulating periodontal bone remodeling, which deserves further study for potential clinical application.

Transcatheter Closure of Patent Ductus Arteriosus under Echocardiography Guidance: A Randomized Controlled Noninferiority Trial.

BACKGROUND: Percutaneous occlusion under fluoroscopy guidance has become the preferred method for the treatment of patent ductus arteriosus (PDA). To avoid radiation exposure and contrast agent use, PDA occlusion under transthoracic echocardiography (TTE) guidance was conducted. OBJECTIVES: We assessed the hypothesis that the success rate of percutaneous PDA occlusion under TTE was noninferior to that under fluoroscopy guidance. METHODS: In this single-center trial, 100 patients were randomly assigned in a 1 : 1 ratio to the TTE group (n = 50) or to the fluoroscopy group (n = 50). The primary endpoint was the success rate of occlusion, with the noninferiority margin set at 8% for the between-group difference in intention-to-treat analysis. Secondary endpoints were hospitalization duration, cost, procedure time, and rate of adverse events including occluder migration, hemolysis, peripheral vascular complications, and residual shunt at 1-month and 12-month follow-up. RESULTS: Patient, defect, and device characteristics were similarly distributed between groups. The success rate of occlusion was 98% for the TTE group and 100% for the fluoroscopy group (absolute difference: -2%; 95% confidence interval: -5.9% to 1.9%). Cost and procedure duration were significantly lower in the TTE group, without adverse events in either group at a median of 12.0 months (range, 10.0-15.5 months) of follow-up. CONCLUSION: Percutaneous PDA occlusion can be performed via TTE guidance safely and effectively, and the success rate of the TTE-guided procedure was noninferior to that under fluoroscopy guidance, with reduced cost and procedure time. The trial is registered with http://www.chictr.org.cn (ChiCTR-ICR-15006334).

Orthodontic incisor retraction caused changes in the soft tissue chin area: a retrospective study.

BACKGROUND: To investigate the area and morphological changes around the soft tissue chin after orthodontic incisor retraction. METHODS: Fifty-nine female adults with bimaxillary protrusion requiring extraction of four premolars were included in the study. Cephalograms were taken before (T0) and after (T1) orthodontic treatment. The soft tissue changes, including the area, thickness and morphology were measured. Paired-t tests were performed for statistical comparisons. Pearson correlation analyses and backward multivariate regression analyses were used to identify the relationship between the soft tissue changes and incisor retraction. RESULTS: Following the incisor retractions (5.35 ± 1.79 mm and 4.42 ± 1.62 mm for the upper and lower, respectively), there was a significant increase in the soft tissue thickness of L1c-LL (0.64 ± 1.67 mm, P = 0.025) and Pog-Pog' (0.44 ± 1.10 mm, P = 0.022), and a significant decrease in the soft tissue thickness of B-B' (1.21 ± 1.34 mm, P <  0.01). Changes in the area of soft tissue chin and lower lip were not statistically significant (P > 0.05). Pearson coefficient between the thickness changes of B-B' and the retraction of lower incisors was - 0.376. The multiple correlations between the soft tissue thickness changes and incisor retractions were Y = 1.02-0.42a + 0.42b for L1c-LL, and Y = 0.17-0.31b for B-B'. CONCLUSIONS: The orthodontic incisor retraction could cause soft tissue thickness changes (i.e. an increase in L1c-LL and Pog-Pog' and a decrease in B-B') without area changes.